The proposed 2-year study will be a block, stratified, randomized controlled trial. Once consented and enrolled, participants will be randomly assigned to either the peer-enhanced intervention or referred to standard clinical care. The investigators will enroll 80 former inmates with chronic HCV who have been released from incarceration within the past 6 months. Those eligible will also be over the age of 18 and fluent in English or Spanish. If they have a life expectancy of less than one year they will be deemed ineligible. During the first year the investigators will recruit and enroll 80 former inmates of the NYC jails or NYS prisons with chronic HCV into the HCV-ACCELERATE intervention. It is expected that enrollment will be completed by the fourth quarter of the first year. This will allow sufficient time for HCV treatment uptake, completion, determination of SVR, and assessment of reinfection. Individual participant follow-up will be 3 months on average for treatment, 3 months for SVR, and 3 months to assess for reinfection.~Our primary outcome, linkage to care, will be defined as a visit with an HCV treatment provider. Secondary outcomes will include time to HCV treatment initiation (# of days following release from the correctional setting), treatment completion, sustained virologic response (SVR), HCV risk behaviors/substance use as determined by ACASI (Audio Computer Assisted Self Interview) interviews, re-incarceration (as determined by Department of Corrections, DOC, inmate lookup system), ED utilization, and hospitalizations. Elucidating the barriers and facilitators in the re-entry care cascade (as well as how they may be overcome) will be critical in designing sustainable models of care for HCV-infected former inmates.~The investigators hypothesize that a peer-enhanced strategy will be more effective than standard referral in improving linkage to, and retention in, HCV care among individuals recently released from correctional settings.
The overarching goal of this study is to develop a peer-based care coordination intervention for individuals with HCV who were recently released from correctional settings to promote linkage to and retention in HCV care. The investigators will assess the existing barriers and facilitators of HCV treatment initiation, HCV treatment completion, and sustained virologic response among individuals recently released from the New York City (NYC) jails or New York State (NYS) prisons in a randomized control trial. This study will assess the feasibility and process measures of a peer-enhanced HCV care coordination intervention among recently incarcerated individuals.