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Working Toward Eradication (Hepatitis C/HIV Coinfection Presentation) - Alex Shirreffs, PDPH


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At the October 2016 meeting of the Philadelphia Ryan White Part A Planning Council, Alex Shirreffs of the Philadelphia Department of Public Health discussed an ongoing project to improve the care continuum for HIV/HCV co-infected people of color.

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Working Toward Eradication (Hepatitis C/HIV Coinfection Presentation) - Alex Shirreffs, PDPH

  1. 1. WORKING TOWARDS ERADICATION A Project to Improve the Care Continuum for HIV/HCV Co-Infected People of Color Alex Shirreffs, MPH Philadelphia Department of Public Health
  2. 2. HRSA’s Aims Over 3 years (Sept 2016 – Sept 2019) we will: • Increase jurisdiction-level capacity to provide comprehensive screening, care and treatment of hepatitis C among HIV/HCV co-infected people of color • Increase numbers of HIV/HCV co-infected people of color who are diagnosed, treated and cured of HCV infection
  3. 3. Why Do We Need This Grant Now? • Treatment and Care for HIV and HCV Have Improved • People with HIV are living longer, treatments have become simpler • Most people CURED of hep C in <12 weeks, tx has limited side effects • People with HIV prioritized for HCV care under PA Medicaid • ADAP will cover tx for all people with HIV/HCV • Robust Data • Enhanced data available to drive better patient care • Opportunity to combine HIV and HCV data for exciting new analyses • Sexual transmission, impact of opioid epidemic on HIV/HCV rates, how does co-infected continuum compare to mono-infected continuums? • Changing Landscape of Federal Funding Priorities • Care as prevention, focus on medical model • Builds on PCSI – is integration the future of LHDs? • DOHs starting to roll out Hep C Elimination campaigns/strategies • Allows us to work towards bold cure rates in a smaller HCV subset
  4. 4. Expectations: Pre-Implementation • Within the first six months of the award we will: • Conduct a needs assessment to identify gaps in RW services provision in existing HCV screening, care, and treatment system of Philadelphia EMA • Prepare and submit needs assessment with identified gaps and barriers to ETAC • Conduct a patient HCV care and treatment knowledge assessment among HIV/HCV co-infected people of color • Conduct a provider assessment to identify gaps in knowledge, skills, and behavior regarding HCV services • Develop a Project Implementation Plan
  5. 5. Expectations: Project Implementation • Implement a plan to enhance existing HCV screening, referral, and treatment system for HIV/HCV co-infected people of color and describe all systems components, including: • Provider training • Patient education • Practice transformation • Enhanced HCV screening • Improved Access to HCV Care and Treatment • Medication Adherence Support • Document Project (Manuals, tools, policies, protocols, etc…) • Host 1 site visit/year with ETAC and SPNS Project Officer
  6. 6. Proposal Highlights What made Philly a strong applicant? • Well established RW Part A site • More robust hepatitis infrastructure than most local HDs • VHPC and Hepatitis Surveillance Team • HepCAP coalition has convened community • Already created a model for improving HCV cascade through training, linkage support that we could modify for grant purpose • Good mix of RW providers who are already scaling up HCV services • Use our local experts for peer-to-peer learning, resource sharing among HIV care sites • Strong relationship with Health Federation and Mid- Atlantic AETC • Experience with training and capacity building support for PDPH
  7. 7. BECAUSE WE CAN DO THIS! PDPH applied because we have the resources in this city to cure all people living with HIV and HCV of their HCV infection: • Excited health department team • A wealth of local experts in HIV and Hep C • Robust HIV care and social service network • A population of patients who can benefit from an HCV CURE!
  8. 8. Next Steps Month Project Actions Oct 2016 • Begin needs assessment • Who should we be talking to from YOUR site? Jan 2017 • Begin to use IRB-approved Patient Knowledge Assessment tool (when available) • Begin to use IRB-approved Provider Assessment tool Mar 2017 • Complete project needs assessment and submit to ETAC • Submit results of Patient and Provider Assessments to ETAC Apr 2017 • Begin to develop Philadelphia EMA implementation plan
  9. 9. Thank You! Alex Shirreffs 215-985-6462