Author information

¹Disease Elimination, Burnet Institute, Melbourne 3004, Australia.

²Cairns Sexual Health Service, Cairns 4870, Australia.

³School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia.

⁴Melbourne School of Population and Global health, University of Melbourne, Melbourne 3010, Australia.

⁵Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne 3086, Australia.

⁶Department of Infectious Diseases, Alfred Health and Monash University, Melbourne 3004, Australia.

⁷School of Medicine and Dentistry, James Cook University, Townsville 4814, Australia.

Abstract

Background: Understanding the effectiveness of novel models of care in community-based settings is critical to achieving hepatitis C elimination. We conducted an evaluation of a hepatitis C model of care with financial incentives that aimed to improve engagement across the hepatitis C cascade of care at a sexual health service in Cairns, Australia.

Methods: Between March 2020 and May 2021, financial incentives were embedded into an established person-centred hepatitis C model of care at Cairns Sexual Health Service. Clients of the Service who self-reported experiences of injecting drugs were offered an AUD 20 cash incentive for hepatitis C testing, treatment initiation, treatment completion, and test for cure. Descriptive statistics were used to describe retention in hepatitis C care in the incentivised model. They were compared to the standard of care offered in the 11 months prior to intervention.

Results: A total of 121 clients received financial incentives for hepatitis C testing (antibody or RNA). Twenty-eight clients were hepatitis C RNA positive, of whom 92% (24/28) commenced treatment, 75% (21/28) completed treatment, and 68% (19/28) achieved a sustained virological response (SVR). There were improvements in the proportion of clients diagnosed with hepatitis C who commenced treatment (86% vs. 75%), completed treatment (75% vs. 40%), and achieved SVR (68% vs. 17%) compared to the pre-intervention comparison period.

Conclusions: In this study, financial incentives improved engagement and retention in hepatitis C care for people who inject drugs in a model of care that incorporated a person-centred and flexible approach.