Public health & epidemiology
Strategies to increase hepatitis C testing and linkage to curative treatments in primary care and community settings.
Broad, practical guidance for expanding hepatitis C testing across primary care and community venues, with actionable steps to ensure rapid linkage to curative therapies and improved patient outcomes.
Published by
Scott Morgan
July 29, 2025 - 3 min Read
As hepatitis C management evolves, primary care clinics and community health settings play a pivotal role in expanding access to testing and curative therapies. The first priority is normalizing hepatitis C screening by integrating it into routine care, rather than treating it as a specialized procedure. Clinics should adopt opt-out testing policies where feasible, supported by straightforward consent processes and clear information about benefits and risks. Electronic health records can prompt clinicians when testing is due, and standing orders can offload decision-making from individual practitioners. Community sites should adapt outreach to local populations, using culturally appropriate materials and trusted community workers to reduce stigma and encourage individuals to learn their status without fear.
Equally important is ensuring rapid linkage to care after a positive test. Streamlined care pathways that begin on the same day as the diagnosis reduce loss to follow-up and foster timely treatment initiation. Having dedicated care coordinators or navigators who guide patients through evaluation, fibrosis assessment, and eligibility criteria for antiviral therapy improves outcomes. Multidisciplinary teams, including nurses, social workers, and peer navigators, help address barriers such as housing insecurity, transportation, and financial concerns. Clinics should offer flexible appointment times, telemedicine options, and same-day laboratory testing to accelerate the treatment trajectory and minimize patient drop-off.
Bridging gaps between testing and treatment through coordinated care.
To broaden testing reach, health systems should partner with pharmacies, workplaces, schools, and faith-based organizations. Pharmacists can provide confidential testing services, while workplace screenings reach adults who may lack routine primary care. Schools and community centers can host screening events with rapid results, ensuring privacy and counseling. In all settings, messaging must emphasize that hepatitis C is curable with modern antivirals, that testing is quick and confidential, and that early treatment yields the best health outcomes. Data sharing agreements and privacy safeguards are essential to maintain trust during community outreach efforts and to protect individuals’ information.
Training and capacity-building are critical for sustained success. Frontline staff require concise, evidence-based scripts and decision aids to discuss testing and treatment options without causing alarm. Regular updates on guideline changes, patient education resources, and culturally tailored materials empower teams to communicate effectively. Quality improvement cycles, including monthly reviews of testing rates, linkage-to-care metrics, and patient satisfaction, help identify gaps. Investment in point-of-care testing devices and rapid RNA assays can further shorten the time from screening to treatment, ensuring patients receive timely care regardless of where they are seen.
Integrating peers and frontline staff strengthens trust and access.
Financial and policy barriers often hinder testing and treatment uptake. Programs that remove or reduce out-of-pocket costs for testing and antiviral therapy improve equity. Health plans can pilot zero-cost hepatitis C treatment for underserved populations, while patient assistance programs ease co-pays and diagnostic fees. Transparent communication about coverage, eligibility, and the treatment timeline reduces confusion. Additionally, policies that support same-day referral and telemedicine can overcome geographic and transportation barriers. By aligning reimbursement, patient support, and streamlined pathways, health systems can sustain improved testing and higher initiation rates for curative regimens.
Community health workers and peer navigators play a transformative role in engagement. Individuals who share lived experience can demystify hepatitis C, address stigma, and model successful treatment journeys. Training these workers in motivational interviewing, confidential handling of sensitive information, and local resource mapping enhances their effectiveness. They can accompany patients to appointments, assist with insurance enrollment, and connect people to social supports such as housing, food security, and legal services. Strong peer networks also create support communities that encourage ongoing adherence and reduce the likelihood of relapse or disengagement during treatment.
Data-driven learning loops guide ongoing improvement and accountability.
Digital health tools complement in-person efforts by extending reach and convenience. Secure patient portals enable appointment scheduling, test result viewing, and direct messaging with care teams. Mobile apps can deliver medication reminders, symptom checklists, and educational content in accessible formats. Telehealth visits reduce travel burdens and offer privacy for sensitive discussions. However, digital solutions must be inclusive, with options for individuals who have limited internet access or low digital literacy. Providing devices, data subsidies, or caregiver-assisted access helps ensure that technology enhances rather than widens disparities.
Continuous learning and measurement ensure quality improvement across settings. Robust data systems track testing volumes, positivity rates, treatment initiation, and cure outcomes. Regular dashboards help managers spot trends, identify underperforming clinics, and celebrate successes. Feedback loops from patients and community partners inform iterative changes to processes, materials, and outreach approaches. Sharing lessons across sites accelerates improvement, while independent audits reinforce accountability. Ultimately, transparent reporting sustains confidence among patients, clinicians, and policymakers that hepatitis C elimination efforts remain effective and ethically sound.
Collaborative systems and surveillance sustain progress toward elimination.
A patient-centered environment is essential to encourage testing and treatment acceptance. Staff should be trained to listen nonjudgmentally, explain results with clear language, and respect patient autonomy. Counseling should cover transmission, prevention, and the importance of completing therapy. For those hesitant about antiviral therapy, clinicians can present risk-benefit information, address side effects, and share success stories from diverse communities. Privacy is critical; patients must feel secure that personal health information remains confidential. Creating welcoming spaces, reducing wait times, and offering culturally resonant materials can significantly improve willingness to test and pursue cure.
Collaboration with public health authorities strengthens population-level impact. Local health departments can provide aggregate data, contact tracing support, and community-wide education campaigns. Joint efforts with laboratories ensure rapid result reporting and consistent follow-up messaging. Coordinated procurement of antivirals and testing supplies stabilizes supply chains and minimizes shortages. Such partnerships enable timely surveillance of hepatitis C incidence, outcomes, and emerging resistance patterns, guiding resource allocation and ensuring that testing and treatment remain available where they are most needed.
In parallel, targeted outreach to key populations can dramatically change the testing landscape. People who inject drugs, prisoners, and marginalized communities often bear a disproportionate burden of hepatitis C but face barriers to care. Tailored interventions—such as low-threshold testing sites, harm-reduction integration, and mobile clinics—meet them where they are. Outreach should respect lived experiences, incorporate peer-led education, and provide immediate access to linkage services. By reducing stigma and removing practical obstacles, programs can increase testing uptake and ensure that individuals are connected to curative therapies before disease progression limits options.
Finally, sustainability hinges on political will, funding, and community ownership. Long-term success requires explicit leadership commitments, stable financing for testing and treatment, and ongoing community participation in planning and evaluation. Policies should protect patient privacy while enabling efficient care pathways, and professional societies can endorse standardized practices that improve consistency. Communities that invest in education, stigma reduction, and access to care are better positioned to achieve durable gains. When primary care and community settings collaborate as equal partners, hepatitis C testing and treatment become a routine, equitable part of healthcare for all.
