The C No More van with colourful sandwich board sign advertising liver health check and hepatitis C finger prick testing.

Thom Cookes

The C No More project: Community corrections nurse-led model of care to eliminate hepatitis C

People completing community corrections orders share common risk factors for hepatitis C transmission with people in prison, a group with known high hepatitis C prevalence.

However, they represent a much larger population not currently targeted by hepatitis C treatment programs. This study offers free hepatitis C testing and treatment to people in community corrections and assesses the effectiveness of the model of care.

Objective

We aim to implement and evaluate a nurse and peer partnership-led mobile model of hepatitis C care. The model utilises point-of-care testing and rapid DAA treatment initiation for people with criminal legal system involvement at selected sites in Victoria.

Timeline

2023–⁠2026.

Approach

A mobile, medically equipped van staffed by a hepatitis specialist nurse and peer support worker parks adjacent to metropolitan community corrections facilities. The service offers hepatitis C testing for individuals attending these sites. Participants are tested for current hepatitis C infection using point-of-care fingerstick testing, which returns a result in around 60 minutes.

All participants with current hepatitis C infection are offered a clinical assessment and DAA therapy in line with current Australian guidelines.

Following completion of DAA therapy, participants are offered hepatitis C RNA PCR testing to confirm cure.

Hepatitis C information and education are initiated with anyone having contact with the clinic team. This includes harm reduction strategies where appropriate.

Phase 2 (May 2025 to April 2026) offers vaccinations and introduces screening for sexually transmitted infections.

Nurse Georgia demonstrates finger prick testing with Mark Belzer in the C no more mobile hepatitis C testing van.

Finger prick testing takes only an hour.

Community impact

We're using a mixed-methods design to assess the service. This includes qualitative, sociodemographic, clinical and operational data to evaluate the acceptability, feasibility, effectiveness and cost-effectiveness of the mobile model of care.

Our study:

provides convenient, accessible testing and treatment for a group that face barriers accessing healthcare with an opportunity to engage/re-engage in hepatitis C care
tests the feasibility and acceptability of rapid point-of-care hepatitis C testing in a non-traditional, non-clinical setting
provides ‘proof of concept’ evidence of feasibility, acceptability and effectiveness for scaling up the model of care
provides cost-per-treatment episode data to compare the model’s cost against existing primary care and in-prison hepatitis services
estimates the cost-effectiveness of the C No More model of care.

Student opportunities

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Understanding hepatitis C treatment complexity through lived experience

This project will support the development of a hepatitis C treatment complexity tool by exploring the lived experiences of people receiving care through the C No More program.

You'll conduct semi-structured interviews with approximately 10 participants representing a range of treatment experiences and support needs. Interviews will explore barriers and facilitators to treatment engagement, support requirements and perceptions of factors contributing to treatment complexity.

You'll also analyse data using thematic analysis to assess the face validity of the preliminary tool and identify factors not captured in quantitative analyses. The findings will ensure the tool reflects lived experience and informs tailored models of hepatitis C care.