ABSTRACT
BackgroundAt the start of the Coronavirus pandemic the UK Government pledged to house all rough-sleepers in temporary accommodation. This provided healthcare workers with a unique opportunity to access this ‘hard-to-find’ group, offer blood borne viruses screening (BBVS) and link clients testing positive into individualised treatment.ApproachA collaborative working group (HIV clinicians, HIV prevention specialists, hepatitis C outreach nurses and rough-sleepers health-engagement workers) established comprehensive risk-assessments, PPE supplies and dried blood spot procurement. Two experienced outreach workers worked along-side trusted homeless key-workers to offer BBVS (HIV, hepatitis B&C) in hotels, a hostel and student halls over 13-weeks (Jun-Sep 2020). Clients were offered £5 food-voucher for participating.Outcomes270 clients were housed during this time, 256 (95%) were offered BBVS;192 (72%) tested. 148 (77%) tested ‘mainly due to the incentive’. Of the 192 testers the median age (range) was 40y (18–69). Clients were mainly male 161 (83%);white-British 164 (85%) and heterosexual 179 (93%). 54 (28%) stated previous IVDU;39 (20%) other drug use and 92 (48%) prison as risk-factors. 70 (36%) had not previously tested. 31 (16%) were hepatitis C antibody positive;13 (7%) RNA positive. To date 4 have started treatment;5 deferred;3 did not engage with services despite being aware of the diagnosis;1 left the area. No new HIV diagnoses (two clients re-engaged with care). Most clients considered the service good or excellent, and would recommend (99%). Challenges included lab delays due to competing Covid-19 testing and engaging disenfranchised clients.Innovation and SignificanceThis project brought together a multidisciplinary collaboration, drawing on specialist knowledge to meet complex needs. Despite challenges during a pandemic, we obtained a useful snap-shot of BBV rates. Offering an incentive to a cohort sensitised to BBVS was important. New outreach testing opportunities were identified which will be progressed in 2021.