ABSTRACT
BACKGROUND: COVID-19 has hindered hepatitis C virus (HCV) and HIV screening, particularly in marginalised groups, who have some of the highest rates of these conditions and lowest rates of COVID-19 vaccination. We assessed the acceptability of combining HCV testing with COVID-19 vaccination in a centre for addiction services (CAS) in Barcelona and a mobile testing unit (MTU) in Madrid, Spain. METHODS: From 28/09/2021 to 30/06/2022, 187 adults from marginalised populations were offered HCV antibody (Ab) testing along with COVID-19 vaccination. If HCV Ab+, they were tested for HCV-RNA. MTU participants were also screened for HIV. HCV-RNA+ and HIV+ participants were offered treatment. Data were analysed descriptively. RESULTS: Findings show how of the 86 CAS participants: 80 (93%) had been previously vaccinated for COVID-19, of whom 72 (90%) had the full first round schedule; none had a COVID-19 vaccine booster and all received a COVID-19 vaccine; 54 (62.8%) were tested for HCV Ab, of whom 17 (31.5%) were positive, of whom all were tested for HCV-RNA and none were positive. Of the 101 MTU participants: none had been vaccinated for COVID-19 and all received a COVID-19 vaccine; all were tested for HCV Ab and HIV and 15 (14.9%) and 9 (8.9%) were positive, respectively; of those HCV Ab+, 9 (60%) were HCV-RNA+, of whom 8 (88.9%) have started treatment; 5 (55.6%) of those HIV+ had abandoned antiretroviral therapy, of whom 3 (60%) have re-started it. CONCLUSIONS: The intervention was accepted by 54 (62.8%) CAS participants and all MTU participants and can be used in marginalised communities.
The COVID-19 pandemic has reduced the numbers of people being screened to determine whether they are infected with the hepatitis C virus (HCV) or HIV. This is particularly the case for marginalised populations, which include people with substance use disorders (e.g., injecting drug use), those who are experiencing homelessness, and those with mental health disorders. This study explored whether these populations were willing to be tested for HCV after receiving a COVID-19 vaccination in a centre for addiction services in Barcelona and a mobile testing unit (MTU) in Madrid, Spain. Those attending the MTU were also screened for HIV. Most participants were both vaccinated and tested for HCV and HIV, as applicable, when offered. Applying this approach more widely could improve healthcare reach among marginalised populations.
ABSTRACT
INTRODUCTION: COVID-19 has had a great impact on mental health in the general population. However, few studies have focused on patients with substance use disorders (SUDs). This research aimed to compare the clinical status and substance use patterns of SUD outpatients, before and during confinement due to the COVID-19 pandemic. METHODS: This multicentre study recruited 588 patients (29.2% women; M age = 47.4 ± 11.7 years) in thirteen centres for addiction treatment in Catalonia, Spain. All subjects were evaluated with validated instruments and ad hoc questionnaires. The sample was divided into 3 groups according to how the substance consumption pattern changed during lockdown (maintained pattern, worsened pattern, and improved pattern). RESULTS: More than 62% of the patients maintained or worsened their consumption pattern during confinement, and about 38% improved throughout this time. Diverse factors were associated with the changes in pattern like age, addiction severity, psychological distress during lockdown, social and familial issues, and therapeutic variables. CONCLUSION: The home lockdown during the COVID-19 pandemic was associated with major implications for substance consumption and psychiatric distress among SUD outpatients. Considering this, the need to plan appropriate interventions in cases of similar health crises is highlighted.