2026 Webinar – Viral Hepatitis and Sexual Health in LGBTQ+ Communities and Beyond ondemand-Low-Barrier High-Impact

Low-Barrier High-Impact

Pdf Summary

The document argues that hepatitis C virus (HCV) elimination efforts should focus on where high-risk patients already receive care, especially men who have sex with men (MSM) and transgender populations. It opens with a case of a transgender man with fentanyl use, intermittent syringe sharing, unstable housing, lack of insurance, and fear of venipuncture—illustrating the many barriers that prevent diagnosis and treatment.<br /><br />Key points include:<br /><br />- HCV prevalence is high in MSM and transgender communities, with injection drug use and sexualized drug use (“chemsex”) being major drivers of transmission.<br />- Structural factors such as homelessness, incarceration, discrimination, and limited access to healthcare worsen risk and reduce treatment engagement.<br />- Many patients avoid traditional clinics, so effective HCV care must be delivered through low-barrier settings like syringe services programs (SSPs), primary care, HIV/PrEP services, emergency departments, substance use treatment programs, and incarceration settings.<br /><br />The presentation emphasizes “no wrong door” care models that simplify diagnosis and treatment. Recommended strategies include opt-out screening, point-of-care or capillary HCV RNA testing, dried blood spot testing, and reducing the need for multiple visits. Trauma-informed approaches, advanced phlebotomy techniques, and patient support can help people with difficult venous access.<br /><br />It also addresses mental health and drug-drug interactions, noting that most psychiatric and gender-affirming medications are compatible with direct-acting antivirals (DAAs). Treatment should not be delayed because of ongoing substance use or reinfection risk.<br /><br />Finally, the document highlights retention strategies such as patient navigation, peer support, flexible communication, telehealth, transportation help, housing and food support, and co-located services. A model example shows successful HCV cure through an SSP-based, multidisciplinary approach that combined capillary testing, telehealth, case management, medication assistance, and direct treatment delivery.

Keywords

hepatitis C virus

HCV elimination

men who have sex with men

transgender populations

syringe services programs

chemsex

opt-out screening

point-of-care testing

direct-acting antivirals

patient navigation