Testing and linkage to care are important determinants of hepatitis C virus (HCV) treatment effectiveness. Public health clinics serve populations at high risk for HCV. We investigated their potential to serve as sites for HCV testing, initiation of and linkage to HCV care.
Cross-sectional study of patients accessing Sexually Transmitted Infections (STI) care at the Baltimore City Health Department (BCHD) STI clinics, from June 2013 through April 2014. Logistic regression was used to assess factors associated with HCV infection and specialist linkage to care.
Between June 24, 2013 and April 15, 2014, 2681 patients were screened for HCV infection. Overall, 189 (7%) were anti-HCV positive, of whom 185 (98%) received follow-up HCV RNA testing, with 155 (84%) testing RNA positive. Of 155 RNA positive individuals, 138 (89%) returned to the STI clinic for HCV RNA results and initial HCV care including counseling regarding transmission and harm reduction for alcohol, and 132 (85%) were referred to a specialist for HCV care. With provision of patient navigation services, 81(52%) attended an offsite HCV specialist appointment. Alcohol use and lack of insurance coverage were associated with lower rates of specialist linkage (OR 0.4 [95% CI 0.1–0.9] and OR 0.4 [95% CI 0.1–0.9] respectively).