Implementation of a mobile health clinic framework for Hepatitis C virus screening and treatment: a descriptive study.

BACKGROUND

Although treatment for Hepatitis C Virus (HCV) is effective, individuals face access barriers. The utility of mobile health clinics (MHC), effective mechanisms for providing healthcare to underserved populations, is understudied for HCV-related interventions. We aimed to describe implementation of, and factors associated with, screening and treatment via MHCs.

METHODS

Clemson Rural Health implemented a novel MHC program to reach and treat populations at-risk for HCV with a focus on care for uninsured individuals. We examined HCV screening and treatment initiation/completion indicators between May 2021 and January 2023.

FINDINGS

Among 607 individuals screened across 31 locations, 94 (15.5%) tested positive via antibody and viral load testing. Treatment initiation and completion rates were 49.6% and 86.0%, respectively. Among those screened, the majority were male (57.5%), White (61.3%; Black/Hispanic: 28.2%/7.7%), and without personal vehicle as primary transportation mode (54.4%). Injection drug use (IDU) was 27.2% and uninsured rate was 42.8%. Compared to HCV-negative, those infected included more individuals aged 30-44 (52.1% vs. 36.4%,  = 0.023), male (70.2% vs. 55.2%,  = 0.009), White (78.5% vs. 60.2%,  < 0.0001), without personal vehicle (58.5% vs. 43.5%,  = 0.028), IDU (83.7% vs. 21.0%,  < 0.0001), and uninsured (61.2% vs. 48.8%,  = 0.050). Uninsured rates were higher among those initiating compared to not initiating treatment (74.5% vs. 45.3%,  = 0.004).

INTERPRETATION

The MHC framework successfully reaching its target population: at-risk individuals with access barriers to healthcare. The high HCV screening and treatment initiation/completion rates demonstrate the utility of MHCs as effective and acceptable intervention settings among historically difficult-to-treat populations.

FUNDING

Gilead Sciences, Inc., and SC Center for Rural and Primary Healthcare.