Lessons Learned about Barriers to Hepatitis C Testing: Implications for Policy

Abstract

Despite primary prevention efforts to educate the public about hepatitis C, the most prevalent blood-borne human disease in the world today, most Americans remain unaware of their infection status. Widespread screening programs established to identify those at risk have been slow to emerge and difficult to implement, especially when compared to the nation's rapid response to the HIV/AIDS epidemic. Analysis of screening and testing practices among nurses and other clinicians within the Veterans Affairs Administration (VA), the site of the most comprehensive hepatitis C virus outreach program to date, reveals numerous barriers to reaching at-risk veterans. It is worthwhile to examine the VA experience for lessons in how to identify other Americans at risk, particularly those without access to primary care in well-funded, organized systems of care.