<%@LANGUAGE="VBSCRIPT" CODEPAGE="65001"%> Module 4: Improving access to testing

Module 4: Testing and monitoring - section 4

In this document:

Improving access to testing

Activity: Small group work
Section Time: Approximately 45 minutes

In this activity participants consider the various settings where HCV testing can be provided for PWID, appraise its availability in their own area and, identify improvements that may be needed.

Show Slide 4.15 (Group work) to the group as a whole:

To facilitate:

  • Allow 10-15 minutes at most for this part of the activity
  • Using the flipchart to makes notes, encourage participants to identify as many settings as they can suggest

Show Slide 4.16 (Possible HCV testing settings) :

To facilitate:

  • Discuss any settings that have not been mentioned and whether they may be relevant for the participants.

Show Slide 4.17 (Group work) :

Small group exercise:

  • Allow about 30 minutes for this activity (15 in small groups, 15 for feedback)
  • Divide participants into small groups
  • Using flipchart paper, ask each group to list as many responses as possible in a table as follows:


    Current PWID not in treatment

    PWID in treatment

    Ex-PWID no longer in treatment

    Antibody testing




    HCV RNA testing (PCR)




  • Ask people to highlight any of the settings about which they are uncertain
  • Ensure the group identifies someone who will feedback their discussion

To facilitate:

  • Refer to any local or national guidance you used earlier in the module that is applicable
  • Ask each group to summarise key points from their discussion
  • Avoid repetition by getting each group to highlight differences from other groups
  • For settings where people are uncertain about availability, encourage them to investigate this after the training
  • Encourage people to comment on specific improvements that they would prioritise to improve access to testing.


Supporting content:

For Belarus, Bulgaria, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Russia, Slovenia, Slovakia, and Ukraine,  Merkinaite and Knerr (2007) summarise the availability of the following infrastructure and services (See table 6, pp.93-5) :

  • Protocols for hepatitis testing
  • HCV testing at NSPs
  • Free HCV testing for PWIDs
  • HCV testing on OST
  • Use of rapid tests
  • HCV testing available in prisons

Obstacles that may be relevant to explore further regarding testing include:

  • PWID access to primary health care
  • The role of medical insurance
  • Exclusion of specific minorities from healthcare in general, which affects their access to testing e.g.
  • Roma, people displaced as a result of conflict, asylum seekers, refugees
  • Stigma and discrimination that occur in specific settings e.g. health care institutions, prisons
  • The availability of HCV treatment
  • Registration or reporting systems that identify PWID and store personal information, especially where this can lead to subsequent transfer of their data to law enforcement agencies.

Factors that generally promote testing include:

  • Cost (free)
  • Anonymity
  • Confidentiality
  • Ease of access and flexibility of the service
  • How friendly and knowledgeable the staff are
  • Links to other drug services
  • The availability of Rapid Tests/Dried Blood Spot Testing.

Merkinaite S and Knerr W (Eds.) (2007) Hepatitis C among injecting drug users in the new EU member states and neighboring countries: situation, guidelines and recommendations. Vilnius: Central and Eastern European Harm Reduction Network (CEEHRN).

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