To evaluate the effectiveness of a simplified HCV testing and treatment algorithm with integrated care delivered via mobile medical units (MMUs) to unhoused people who inject drugs (PWID), addressing significant barriers to care.
Key Findings:
33% of patients in the MMU group initiated treatment compared to 24% in the usual care group (P = .4), indicating no statistically significant difference.
Treatment completion rates were 16% in the usual care group versus 10% in the MMU group, with no significant difference.
SVR12 rates were 12% in the usual care group compared to 4% in the MMU group, also not statistically significant.
MMUs facilitated faster treatment initiation but faced challenges with patient retention and follow-up, impacting overall effectiveness.
Interpretation:
The MMU model showed potential for improving rapid access to HCV treatment, but overall treatment initiation, retention, and cure rates remained low, indicating a need for more effective approaches and further research.
Limitations:
Low overall treatment initiation and retention rates, which may limit the generalizability of the findings.
Challenges in follow-up and patient retention in the MMU model, potentially influenced by external factors such as homelessness and substance use.
Conclusion:
There is a critical need to develop approaches that closely approximate a test-and-treat model to enhance treatment initiation and completion among unhoused PWID, addressing their unique barriers to care.
by Christian B Ramers, Natalie Vawter, Adam Northrup, Stacey L Klaman, Sydney V Lewis, Aaron Tam, Carolina Del Aguila, Robert Lewis, Blanca Mendez, Letty Reyes, Eva Matthews, Sarah Rojas, Job G Godino
