title: Community-based HCV screening: knowledge and attitudes in a high risk urban population.
abstract: BACKGROUND
  In an attempt to curtail the rising morbidity and mortality from undiagnosed HCV (hepatitis C virus) in the United States, screening guidelines have been expanded to high-risk individuals and persons born 1945-1965. Community-based screening may be one strategy in which to reach such persons; however, the acceptance of HCV testing, when many high-risk individuals may not have access to HCV specific medications, remains unknown.
  
  
  METHODS
  We set out to assess attitudes about HCV screening and knowledge about HCV disease at several community-based testing sites that serve high-risk populations. This assessment was paired with a brief HCV educational intervention, followed by post-education evaluation.
  
  
  RESULTS
  Participants (n = 140) were surveyed at five sites; two homeless shelters, two drug rehabilitation centers, and a women's "drop-in" center. Personal acceptance of HCV testing was almost unanimous, and 90% of participants reported that they would still want to be tested even if they were unable to receive HCV treatment. Baseline hepatitis C knowledge was poor; however, the brief educational intervention significantly improved knowledge and increased acceptability of testing when medical access issues were explicitly stated.
  
  
  CONCLUSIONS
  Despite inconsistencies in access to care and treatment, high-risk communities want to know their HCV status. Though baseline HCV knowledge was poor in this population, a brief on-site educational intervention improved both knowledge and acceptability of HCV testing and care. These data support the establishment of programs that utilize community-based screening, and also provide initial evidence for acceptance of the implementation of the recently expanded screening guidelines among marginalized communities.
authors: Division of Infectious Diseases and International Health, Duke University Medical Center, Box 102358, Durham, NC 27710, USA. bnorton@montefiore.org.
authors: Brianna L
authors: BL
authors: Norton
authors: Corrine I
authors: CI
authors: Voils
authors: Sarah H
authors: SH
authors: Timberlake
authors: Emily J
authors: EJ
authors: Hecker
authors: Neela D
authors: ND
authors: Goswami
authors: Kim M
authors: KM
authors: Huffman
authors: Anneka
authors: A
authors: Landgraf
authors: Susanna
authors: S
authors: Naggie
authors: Jason E
authors: JE
authors: Stout
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003153:Community Health Services / Q000458:organization & administration; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D016174:Hepacivirus; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009657:North Carolina; D016320:Substance Abuse Treatment Centers; D014481:United States; D014505:Urban Population; D055815:Young Adult