C No More: A prospective single-arm study to evaluate the effectiveness of a nurse and peer-led mobile model of hepatitis C testing and treatment at community corrections offices.

BackgroundThe community corrections population in Australia shares similar risk factors for hepatitis C virus (HCV) infection with people incarcerated in prisons, but without access to prison-based testing and treatment. While hepatitis C testing and treatment programs are well established in prison settings in Australia, little attention has been paid to equivalent programs in community corrections settings. C No More is a study to evaluate the acceptability and efficacy of a novel, mobile, nurse and peer-led model of hepatitis C testing and treatment at community corrections offices in Melbourne, Australia. MethodsA clinically equipped van staffed by a hepatitis clinical nurse consultant and peer workers will spend scheduled periods parked adjacent to four community corrections offices in metropolitan Melbourne. People attending community corrections offices will be opportunistically approached by a peer worker and invited to undertake hepatitis C testing. Other individuals in the vicinity of the community corrections office may also be invited to access the service. Following enrolment, study staff will conduct hepatitis C point-of-care testing and clinical assessments in the van. Point-of-care HCV antibody tests will be used for initial screening, and where positive, point-of-care HCV RNA tests performed. Participants with self-reported HCV antibody will be reflexed to RNA testing. RNA positive participants will be assessed for rapid treatment initiation, and prescribed DAA treatment. Treatment dispensation will occur from the van or through a community pharmacy. Participants will be monitored throughout treatment and offered point-of-care HCV RNA testing four or more weeks after treatment completion to confirm sustained virological response (SVR-4+). The primary outcomes of this study are the proportion of those who are HCV RNA positive who initiate DAA treatment and the acceptability of this model of care. DiscussionThis study will provide evidence of acceptability, feasibility, and clinical effectiveness of a nurse and peer-led, mobile model of hepatitis C care at community corrections offices. The outcomes of this study will inform other models of care aiming to provide hepatitis C testing and treatment to individuals involved in the criminal justice system. Clinical Trial RegistrationThis study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12623001043628). Date of registration: 27/09/2023.