From principles to practice: Description of a novel equity-based HCV primary care treatment model for PWID.
BACKGROUND
Knowledge is increasing regarding effective models of HCV care for people who inject drugs (PWID). However, examples implementing such models in primary care are lacking, leaving a gap in our applied understanding of how practically we best scale-up such care: this is critical and urgent if the benefits of treatment advances are to be realized for PWID.


OBJECTIVE
The Cool Aid Community Health Centre (CHC) provides HCV programming for PWID, putting recent advances into practice. A case study of the CHC's HCV programming describes the practice experience and outcomes of its novel, multidisciplinary, primary care, inner-city HCV treatment program for PWID. This paper describes how this model of care functions to address the many barriers to treatment and successfully facilitate adherence to treatment.


CONCLUSIONS
Medical advances for HCV will be ineffectual without effective management of complex barriers to care related to substance use, mental health, trauma, poverty, homelessness, criminalization, cultural issues, stigma and marginalization. HCV treatment for PWIDs benefits from low-threshold settings which are culturally appropriate and where trusting relationships between clients and providers are nurtured. Public investment in primary care treatment for PWID living with HCV, including investments in supports that address the social barriers faced by these vulnerable populations would build on existing evidence and improve HCV outcomes for PWID.
Cool Aid Community Health Centre, 1st Floor 713 Johnson Street, Victoria, BC, Canada V8W 1M8. Electronic address: rmilne@coolaid.org.
Rozalyn
R
Milne
UBC Department of Family Practice, Cool Aid Community Health Centre, 1st Floor 713 Johnson Street, Victoria, BC, Canada V8W 1M8.
Morgan
M
Price
School of Social Work, University of Victoria, Box 1700 STN CSC, Victoria, BC, Canada V8W 2Y2.
Bruce
B
Wallace
Cool Aid Community Health Centre, 1st Floor 713 Johnson Street, Victoria, BC, Canada V8W 1M8.
Anne
A
Drost
Cool Aid Community Health Centre, 1st Floor 713 Johnson Street, Victoria, BC, Canada V8W 1M8.
Irene
I
Haigh-Gidora
Cool Aid Community Health Centre, 1st Floor 713 Johnson Street, Victoria, BC, Canada V8W 1M8.
Frank A
FA
Nezil
UBC Department of Family Practice, Cool Aid Community Health Centre, 1st Floor 713 Johnson Street, Victoria, BC, Canada V8W 1M8.
Chris
C
Fraser
D001955:British Columbia; D006297:Health Services Accessibility; D006526:Hepatitis C / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D006801:Humans; D010349:Patient Compliance / Q000523:psychology; D011320:Primary Health Care / Q000379:methods*; D016730:Program Development; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000523:psychology
Community health centre; Drug use; HCV; Health; Hepatitis C; PWID; Primary care