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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, but represent a much larger population who are not currently targeted by hepatitis C treatment programs. This study will offer free hepatitis C testing and treatment to people in community corrections and assess the effectiveness of the model of care.

To implement and evaluate a nurse- and peer-led mobile model of hepatitis C care utilising point-of-care testing for hepatitis C RNA and same-day DAA treatment initiation for people completing community corrections supervision orders at selected sites in Victoria.

2023–⁠2025

A mobile van fitted with medical equipment and staffed by a hepatitis nurse practitioner and peer support worker will park in the vicinity of three metropolitan community corrections facilities to offer hepatitis C testing for individuals attending these sites.

Participants will be tested for current hepatitis C infection using point-of-care fingerstick testing through the mobile van service, which returns a result in ~60 mins.

All participants who have current hepatitis C infection will be offered a clinical assessment and DAA therapy in line with current Australian guidelines.

Following completion of DAA therapy, participants will be offered hepatitis C RNA PCR testing to confirm cure. Hepatitis C information and education will be initiated with anyone having contact with the clinic team, including harm reduction strategies where appropriate.

Using a mixed methods design, we will utilize qualitative, sociodemographic, clinical and operational data to evaluate the acceptability, feasibility, effectiveness and cost-effectiveness of the nurse- and peer-led mobile model of care for the community corrections population.

This study will:

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

Doctor Rebecca Winter

Please contact Doctor Rebecca Winter for more information about this project.

EMAIL

Funding
Partners

  • Gilead Sciences, Investigator Initiated
  • St Vincent’s Hospital Inclusive Health Award

Partners +
Collaborators

  • St Vincent’s Hospital Melbourne (Prof Alexander Thompson, A/Prof Jacinta Holmes, Dr Tim Papaluca)
  • Harm Reduction Victoria (Sione Crawford, Jane Dicka)