A Non-Specialist Treatment Model for Hepatitis C Virus (HCV) in Canadian Carceral Settings: A Telemedical Focus

Abstract

Hepatitis C virus (HCV) is a pronounced health problem in carceral settings globally. For Canadian prisons, it is estimated that approximately 25% of those incarcerated have been previously exposed to HCV. Despite being a high prevalence context, Canadian corrections facilities have largely failed to provide adequate care to those with HCV due to their reliance on traditional treatment models. Specifically, this involves hospital-based specialist clinics for patients in corrections facilities nearby – a practice known to be associated with a low incidence of treatment initiation. This paper will explore the use of a contemporary model premised on empowering non-specialist care and the use of telemedicine. This model has found success within other global settings, as will be discussed using case studies from Australia and the United States, and other HCV literature. With the WHO setting an ambitious 90% HCV global reduction goal by 2030, it has become imperative that Canada prioritizes high prevalence populations, such as those in carceral settings, and in turn, looks to more efficient and targeted models of HCV care for these individuals.