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.

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. 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. 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. 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. 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. 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. 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. 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. Thank You!
Alex Shirreffs
Alexandra.shirreffs@phila.gov
215-985-6462