Recommendations for Implementing Hepatitis C Virus Care in Homeless Shelters: The Stakeholder Perspective

• DOI: 10.1002/hep4.1492
• Publication Date: 2020-03-04T07:10:00Z
• Authors: J. Konadu Fokuo; Carmen L. Masson; August Anderson; Jesse Powell; Dylan Bush; Margaret Ricco; Barry Zevin; Claudia Ayala; Mandana Khalili
• Keywords: Outreach; Receipt

Compared with the general population, homeless individuals are at higher risk of hepatitis C infection (HCV) and may face unique barriers in receipt HCV care. This study sought perspectives key stakeholders toward establishing a universal screening, testing, treatment protocol for accessing shelters. Four focus groups were conducted shelter staff, practice providers, social service outreach workers (n = 27) San Francisco, California, Minneapolis, Minnesota. Focus evaluated societal, system, individual‐level facilitators to testing management. Interviews transcribed analyzed thematically. The societal‐level identified lack insurance, high‐out‐of‐pocket expenses, restriction access due active drug and/or alcohol use, excessive paperwork required authorization from payers. System‐level included workforce constraints limited health care infrastructure, stigma, low knowledge treatment, existing policies. At individual level, client competing priorities, behavioral concerns, attitudes. Facilitators system level integration setting high acceptability buy in, linkage providers. Conclusion: Despite respect scale‐up services shelters, there was broad support increasing capacity provision settings. Recommendations settings discussed.