Integrating Rapid Hepatitis C Testing into a Community-Based HIV Testing Program Targeting MSM

Background: Rapid hepatitis C (HCV) testing has recently become available, but little is known about HCV risk factors and rates of detecting new HCV infections among individuals presenting for HIV testing at community-based sites that target men who have sex with men (MSM). This information could help HIV testing programs determine whether to consider offering rapid HCV testing.

Methods: We piloted rapid HCV testing in a community-based HIV testing site that targets MSM. Counselors screened clients presenting for HIV testing for HCV risk and offered them a rapid HCV test along with an HIV test if HCV risk was identified.

Results: Over ten months, 64 people received both a rapid HCV and HIV test. 1 client tested reactive for HCV antibodies. The most frequently reported risks of the 64 clients included: MSM who reported unprotected anal sex (44%); received a tattoo or piercing somewhere other than a licensed practice (22%); born between 1945-1965 (20%); ever injected drugs (19%); healthcare, emergency medical, or public safety worker with known exposure to HCV-positive blood (19%); ever incarcerated for more than one month (16%); engaged in sexual practices that involved exposure to blood (11%); engaged in sexual practices that may have caused physical trauma (11%); history of liver disease or abnormal liver blood tests (11%); had a sex partner who was known HCV-positive (10%); and current injection drug use (8%). 31 clients (48%) reported having been tested for HCV previously.

Conclusions: It is feasible to incorporate rapid HCV testing into community-based HIV testing programs targeting MSM, and doing so may result in detection of new HCV cases and increased opportunities to educate clients about HCV. Screening for and education about HCV within the context of HIV screening and risk reduction counseling can enhance HCV prevention and detection efforts.