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Bridging the gap: Improving hepatitis care for patients released from correctional facilities

BCCDC and BCMHSUS focus on improving outcomes for people living with hepatitis C who are incarcerated for World Hepatitis Day, July 28.
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Through the Talk, Link, Call Project, participants will be provided with a cell phone upon release from correctional services.​

A new peer support project intends to improve access to hepatitis C virus (HCV) treatment for people released from provincial corrections. The Test, Link, Call project (TLC project) connects individuals by providing the hardware, a cell phone with a calling/texting plan, linking them to a treatment provider in the community and a person with similar experiences to provide support during the transition.

The project is part of efforts from the BC Centre for Disease Control (BCCDC) and BC Mental Health and Substance Use Services (BCMHSUS), the program responsible for Corrections Health, to improve access to care and treatment for those living with hepatitis infection in correctional facilities. 

In addition to the TLC project, the Pathways to Sexually Transmitted and Blood Borne Infections (STBBI) Care in Prisons project is another collaborative effort between the two organizations to address barriers to testing for those living in prison, and fostering easier access to treatment after release.

The theme for this year's World Hepatitis Day, on July 28, is Hepatitis Can't Wait. 

With a person dying every 30 seconds from a viral hepatitis-related illness globally, the World Health Organization is saying we can't wait to act on viral hepatitis.

Addressing barriers to care and treatment

According to the Blueprint to inform hepatitis C elimination efforts in Canada produced by the Canadian Network for Hepatitis C (CanHepC), nearly 24 percent of people who are incarcerated in federal and provincial correctional facilities have a past or current HCV infection. Stigma, poverty, lack of resources, and unstable housing exacerbate barriers to treatment services upon release from correctional facilities.

"The TLC project is a partnership with Unlocking the Gates Services Society (UTG), which is allowing us to meaningfully involve people with lived experience of incarceration and of hepatitis C infection in our efforts to try to improve the health of marginalised people, as we work towards eliminating viral hepatitis in BC by 2030," said Sofia Bartlett, senior scientist at BCCDC.

Participants will be provided with a cell phone upon release from correctional services and connected with a peer support worker with lived experience of incarceration who has received HCV patient navigation training. 

The project will support a 'warm handover' of patient care from Correctional Health Services to a treatment provider in the community, primarily through telehealth. 

Peers support through TLC

"Peer support is a big part of helping clients during their transition from corrections back to the community—a process that many clients find daunting," says Nancy Desrosiers, provincial executive director for Correctional Health Services and Forensic Regional Clinics.

"During their time in corrections, clients have access to doctors, nurses and specialists. Going back home where support services look different can be overwhelming. This initiative is going to be really important for this population and is a step in the right direction in ensuring that effective care is available to clients, no matter where they are in the province."

Outcomes from the TLC Project may also help provide evidence to expand this peer-supported telehealth approach to other chronic conditions.

"Through my own personal experience with hep C and incarceration, and the fear of the stigma around having this virus, I know how important it is to limit this fear with people who are being released from prison," said Mo Korchinksi, the co-founder and executive director of UTG.

"UTG approaches clients with compassion and empathy, and we meet people where they are at in their journey of leaving corrections. One of the biggest barriers people leaving corrections face is having nothing upon release except the clothes on their backs, so things like the TLC project, which are giving individuals a tool such as a cell phone, and connecting them with health care providers and peer support, are so important in addressing hep C among people in prison."

Transforming testing and care in prisons

Involving peers in the development of programming and services is part of a larger effort by BCCDC and BCMHSUS. They are also collaborating on the STBBI Pathways Project to transform testing and care in provincial correctional centres.

Funded by the Public Health Agency of Canada (PHAC), this two-year project has progressed into Phase 2. After gathering feedback from various stakeholders including people with lived and living experience of incarceration in B.C. about their experiences in accessing testing for STBBIs in BC prisons, the team is now finalizing policy and guidelines for STBBI testing, including Hepatitis B and Hepatitis C, in correctional services.

"We have created a framework that allows people in prison, staff in prisons, and service providers and advocates in the community to all have their voices heard and to help co-design aspects of policies and guidelines, which is something that could be used for future health care re-design projects," said Bartlett.

New policy and guidelines for STBBI testing in prison are expected to be launches by the end of 2021 or early in 2022. The TLC Project is supported by an investigator-initiated grant from Gilead Sciences Canada.




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