During the month of May, the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau (HAB) recognizes Hepatitis Awareness Month and Hepatitis Testing Day, which is on May 19, 2021.
HRSA HAB is raising awareness about the impact of hepatitis C virus (HCV) among people with HIV, and encouraging those with HIV to get tested for HCV. Studies have shown that people with HIV and chronic hepatitis may experience complications with their HIV treatment. Coinfections also puts them at greater risk for liver-related problems including liver cancer and death.
HCV is transmitted through direct contact with blood of an infected person, most commonly through injection drug use, but may also be transmitted via mother to child as well as through sexual contact. Although sexual contact is an uncommon means of transmission, men who have sex with men (MSM) with HIV are at particularly high risk of contracting HCV sexually.
According to current HHS guidelines, all people with HIV should be tested for HCV during their initial evaluation, and those at a high risk for HCV infection should be retested annually.
Ryan White HIV/AIDS Program HIV/HCV Coinfection Initiatives
As part of the Ryan White HIV/AIDS Program (RWHAP) Part F Special Projects of National Significance (SPNS) Program, we implemented several initiatives to increase the capacity to provide comprehensive screening, care, treatment of HIV/HCV coinfection among people of color, with a goal to increase the number of HIV/HCV coinfected people of color diagnosed, treated, and cured of HCV infection.
Through these initiatives, we recognize how important it is for health care providers to be knowledgeable of HCV and exercise cultural humility—so they can build trust with patients and counsel them to get tested for HCV when indicated. We also know there is some hesitancy from people with HIV to get tested for HCV due to potential added stigma and lack of understanding of improved treatment options.
We developed several resources to help health care providers treating people who have or are at risk for HIV/HCV coinfection:
- RWHAP AIDS Education and Training Centers (AETC) Program HIV/HCV coinfection trainings and resources.
- National AETC Curriculum on HIV/HCV Co-infection, which aims to increase health care provider knowledge of HIV and HCV coinfection among people of color in the U.S. and its territories.
- Hepatitis C Prescriber Toolkit, a directory of state-specific resources to help providers navigate health coverage requirements, which impact the prescription of HCV treatment.
- Implementation Guide, Case Studies of Evidence-Informed Interventions, and a Pocket Guide for health care provider sites and community partners with an interest in HCV treatment for their patients coinfected with HIV.
We are also working with Yale University on a SPNS Initiative that aims to link people with HCV and HIV within the RWHAP to care by leveraging existing public health surveillance with clinical data systems. We look forward to sharing the results of this initiative.
HIV, HCV, sexually transmitted infections (STIs), and substance use disorders are all part of a prominent syndemic—a set of linked health problems that interact “synergistically” and contribute to excess burden of disease in a population. I encourage you to review the national strategic plans for 2021-2025 that outline the frameworks for eliminating HIV, HCV, and STIs as public health threats.
HRSA HAB Resources