Hepatitis C Management in Street Settings: Insights from Adults Facing Unsheltered Homelessness
Overview
This study explores the perspectives of patients engaged in street-based treatment for Hepatitis C (HCV) and assesses treatment outcomes. It highlights the challenges faced by individuals experiencing unsheltered homelessness in accessing HCV care.
Background
Hepatitis C virus (HCV) is a significant cause of chronic liver disease in the US, with a disproportionately high prevalence among individuals experiencing homelessness. Barriers to HCV care for this population include limited knowledge, lack of longitudinal care, and competing survival priorities.
Data Highlights
No numerical data or trial data was provided in the source material.
Key Findings
Approximately 1% of the general population is HCV-RNA positive, while prevalence among people experiencing homelessness ranges from 10% to 53%.
In Los Angeles, a study found a 27% HCV positivity rate among adults experiencing homelessness, with nearly half unaware of their infection.
Barriers to HCV care include limited knowledge of transmission and treatment, lack of longitudinal care, and competing survival priorities.
Street medicine models provide full spectrum primary care directly to individuals in their environment, potentially reducing barriers to care.
Direct-acting antivirals (DAAs) have shown high cure rates in sheltered homeless populations, but linkage to care remains a challenge for unsheltered individuals.
Clinical Implications
Healthcare providers should consider the unique barriers faced by individuals experiencing unsheltered homelessness when developing treatment plans for HCV. The street medicine model may serve as an effective approach to improve access to care and treatment outcomes for this marginalized population.
Conclusion
The study underscores the need for innovative care models to address the HCV treatment gap among unsheltered homeless individuals. Further research is warranted to evaluate the effectiveness of these approaches.
The CDC has dropped routine recommendations for six childhood vaccines, shifting decisions to parents and doctors despite decades of evidence showing the shots prevented millions of hospitalizations and tens of thousands of deaths.
