Community-based HCV screening: knowledge and attitudes in a high risk urban population
1 Division of Infectious Diseases and International Health, Duke University Medical Center, Box 102358, Durham, NC 27710, USA
2 Durham VA Medical Center and Division of General Internal Medicine, Duke University Medical Center, Durham, NC, USA
3 School of Nursing, Duke University Medical Center, Durham, NC, USA
4 Division of Rheumatology and Immunology, Duke University Medical Center, Durham, NC, USA
BMC Infectious Diseases 2014, 14:74 doi:10.1186/1471-2334-14-74Published: 10 February 2014
In an attempt to curtail the rising morbidity and mortality from undiagnosed HCV (hepatitis C virus) in the United States, screening guidelines have been expanded to high-risk individuals and persons born 1945–1965. Community-based screening may be one strategy in which to reach such persons; however, the acceptance of HCV testing, when many high-risk individuals may not have access to HCV specific medications, remains unknown.
We set out to assess attitudes about HCV screening and knowledge about HCV disease at several community-based testing sites that serve high-risk populations. This assessment was paired with a brief HCV educational intervention, followed by post-education evaluation.
Participants (n = 140) were surveyed at five sites; two homeless shelters, two drug rehabilitation centers, and a women’s "drop-in" center. Personal acceptance of HCV testing was almost unanimous, and 90% of participants reported that they would still want to be tested even if they were unable to receive HCV treatment. Baseline hepatitis C knowledge was poor; however, the brief educational intervention significantly improved knowledge and increased acceptability of testing when medical access issues were explicitly stated.
Despite inconsistencies in access to care and treatment, high-risk communities want to know their HCV status. Though baseline HCV knowledge was poor in this population, a brief on-site educational intervention improved both knowledge and acceptability of HCV testing and care. These data support the establishment of programs that utilize community-based screening, and also provide initial evidence for acceptance of the implementation of the recently expanded screening guidelines among marginalized communities.