Patient Preferences for Simplified Hepatitis C Testing Modalities
Understanding patient preferences for hepatitis C virus (HCV) testing is essential to improve uptake and support elimination efforts. Despite innovative testing modalities, limited research examines how preferences influence testing choices. A study, published in the International Journal of Drug Policy, compared the uptake of HCV testing modalities when participants were given a choice.
Methods
People at risk of HCV were recruited from community sites in the Australian Hepatitis C Point-of-Care Testing Program. Participants used a visual aid outlining test features, including time to result and collection methods. Those reporting prior HCV infection were offered staff-assisted HCV RNA tests [point-of-care XpertⓇ HCV Viral Load Fingerstick (result in 60 min) or dried blood spot (DBS) (1–2 weeks)]. Participants without prior HCV infection were offered self-administered INSTIⓇ HCV antibody (1 min), staff-assisted INSTIⓇ HCV antibody (1 min), staff-assisted BiolineⓇ HCV antibody (5–20 min), and HCV RNA tests. Participants completed their preferred test, a survey, and received AUD$20 reimbursement. Logistic regression evaluated factors associated with preference for point-of-care RNA testing in those with and without prior HCV infection.
Results
404 people were enrolled (27% female, 75% ever injected drugs). Among those with a history of HCV (n=129), 91% (n=117) selected point-of-care RNA testing and cited the short time to result (52%) and wanting to find out the RNA result today (21%) as key reasons. Among those without a history of HCV (n=275), 72% (n=199) selected staff-assisted INSTIⓇ antibody testing, 19% (n=51) selected point-of-care RNA testing, and 4% (n=10) chose self-administered INSTIⓇ antibody testing. Key reasons for selecting staff-assisted INSTIⓇ included short time to result (75%) and reduced clinic time (8%). Factors associated with selecting point-of-care RNA testing among those without prior infection included recent injecting drug use, homelessness and recent opioid agonist therapy.
Conclusion
Findings highlight the importance of offering rapid, staff-assisted HCV testing to improve uptake among at-risk populations.