Presenting author: DANIL NIKITIN
Presenting author biography:
Since 2007 Danil Nikitin has been representing the Global Health Research Center of Central Asia, and heading the Global Research Institute (GLORI Foundation) since 2011. He earned Masters in Social Work from Columbia in 2006. Danil's research focuses on substance misuse, HIV, GBV, overdose and HCV prevention in drug-using communities.
Feasibility of HCV-specific Self-testing, Brief Intervention and Referral to Treatment as a model for effective linkage to care of Persons who Live with Hepatitis C and Inject Drugs in Kyrgyzstan
DANIL NIKITIN, Sergei Bessonov, Sonjelle Shilton, Elena Ivanova Reipold, Guillermo Z. Martínez-Pérez, Aibek Bekbolotov, Gulmira Suranbaeva, Alla Bessonova
Background: In Kyrgyzstan, hepatitis C virus (HCV) prevalence is around 17-60.4% among persons who inject drugs (PWID). The Harm Reduction Network and GLORI Foundation partnered with FIND, the global alliance for diagnostics, to conduct a Rapid Qualitative Assessment (RQA) of values and preferences of HCV self-testing among PWID in Kyrgyzstan. This partnership then expanded to a study on the feasibility of HCV self-testing among PWID. Within this subsequent feasibility phase, the HCV Screening, Brief Intervention and Referral to Treatment (HCV SBIRT) model of test-and-link to care was piloted and assessed.
Methods: The initial values and preferences inquiry was conducted in 2020 through face-to-face semi-structured individual interviews, focus group discussions, and participatory action-research. In the follow-up feasibility study participants used self-tests in a supervised environment and those who received a reactive result were referred to confirmatory testing. Participants in this study were linked to HCV care through peer navigators using the HCV SBIRT framework. It allowed to screen and assess the severity of substance disorders and hepatitis status, identify the appropriate level of treatment, and apply safe and sustainable linkage of the HCV-positive study participants to specialty care.
Results: Participants in the RQA (n=47) and the feasibility study (n=100) appreciated the community leading role in promoting HCV self-testing and expressed satisfaction with the SBIRT approach. Of 39 participants (10 women) tested HCV Ab+ and referred for confirmatory testing, the HCV viremia was confirmed by DNA quantitative test in 27 participants (6 women). These 27 participants were linked to treatment, completed it and attained sustained virologic response that was confirmed by negative DNA qualitative test. Twenty-seven of the 39 participants who tested HCV Ab+ expressed satisfaction with the pilot intervention.
Conclusions: With the communities leading role, use of HCV SBIRT framework enhanced overall quality of linkage to care and treatment outcomes.