title: Dual-Routine HCV/HIV Testing: Seroprevalence and Linkage to Care in Four Community Health Centers in Philadelphia, Pennsylvania.
abstract: OBJECTIVE
  Despite common risk factors, screening for hepatitis C virus (HCV) and HIV at the same time as part of routine medical care (dual-routine HCV/HIV testing) is not commonly implemented in the United States. This study examined improvements in feasibility of implementation, screening increase, and linkage to care when a dual-routine HCV/HIV testing model was integrated into routine primary care.
  
  
  METHODS
  National Nursing Centers Consortium implemented a dual-routine HCV/HIV testing model at four community health centers in Philadelphia, Pennsylvania, on September 1, 2013. Routine HCV and opt-out HIV testing replaced the routine HCV and opt-in HIV testing model through medical assistant-led, laboratory-based testing and electronic medical record modification to prompt, track, report, and facilitate reimbursement for tests performed on uninsured individuals. This study examined testing, seropositivity, and linkage-to-care comparison data for the nine months before (December 1, 2012-August 31, 2013) and after (September 1, 2013-May 31, 2014) implementation of the dual-routine HCV/HIV testing model.
  
  
  RESULTS
  A total of 1,526 HCV and 1,731 HIV tests were performed before, and 1,888 HCV and 3,890 HIV tests were performed after dual-routine testing implementation, resulting in a 23.7% increase in HCV tests and a 124.7% increase in HIV tests. A total of 70 currently HCV-infected and four new HIV-seropositive patients vs. 101 HCV-infected and 13 new HIV-seropositive patients were identified during these two periods, representing increases of 44.3% for HCV antibody-positive and RNA-positive tests and 225.0% for HIV-positive tests. Linkage to care increased from 27 currently infected HCV--positive and one HIV-positive patient pre-dual-routine testing to 39 HCV--positive and nine HIV-positive patients post-dual-routine testing.
  
  
  CONCLUSIONS
  The dual-routine HCV/HIV testing model shows that integrating dual-routine testing in a primary care setting is possible and leads to increased HCV and HIV screening, enhanced seropositivity diagnosis, and improved linkage to care.
authors: National Nursing Centers Consortium, Philadelphia, PA.
authors: Catelyn
authors: C
authors: Coyle
authors: Philadelphia Department of Public Health, Clinical HIV Services, Philadelphia, PA.
authors: Helena
authors: H
authors: Kwakwa
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods* / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D003151:Community Health Centers / Q000458:organization & administration / Q000706:statistics & numerical data; D003266:Continuity of Patient Care / Q000458:organization & administration; D003955:Diagnostic Tests, Routine / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D015528:HIV Seroprevalence; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015143:Philadelphia / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D055815:Young Adult