People experiencing homelessness are disproportionately infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). In response to COVID-19, cities nationwide temporarily housed people experiencing homelessness in unused hotels. One such initiative in New Orleans also enacted a screening, counseling, and linkage-to-care model for HIV and HCV treatment for this temporarily housed population between May and July 2020.
A non-concurrent cohort study was performed assessing follow up in the treatment of HIV and HCV for this population. Outcome data was collected on seropositive patients’ electronic medical record to assess patient progression through the treatment cascade.
Of 102 unhoused residents, 25 (24.5%) tested HCV seropositive. Of the HCV positive 21/25 (84%) were connected to the associated clinic for follow up care and 10 (40%) obtained HCV treatment medication. Furthermore, all three patients who tested seropositive for HIV either started or re-initiated anti-viral treatment. The greatest barrier to providing medication for the HCV seropositive patients, once care was initiated, was loss-to-follow-up.
Targeting homeless persons living in temporary residences for HCV and HIV screening can be effective at promoting access to care for those infected due to this population’s high HCV seropositivity especially significant if the patient has a history of intravenous drug use or is over the age of 40. However, continued outreach strategies are needed to assist patients in retention of care.