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CitiWide Harm Reduction
 CitiWide Harm Reduction Targets South Bronx and Harlem Communities with Rapid HCV Testing Program
CitiWide Harm Reduction (CitiWide), located in the South Bronx neighborhood of New York City, is an organization committed to improving the health, social and economic status of active drug users who are homeless or at risk of homelessness in New York City. Founded in 1995, CitiWide serves an area that has some of the highest rates of poverty, injection-drug use, HIV and hepatitis C (HCV) in New York City, as well as the nation. Its area also has the highest number of AIDS-related deaths in the city, and hepatitis C rates twice that of the city at large.

In June 2012, CitiWide was among the first organizations in New York State to begin implementing rapid hepatitis C testing with the OraQuick® HCV Rapid Antibody Test. It offers free, side-by-side rapid HCV and HIV testing at its facility as well as through a mobile testing van that travels throughout the area to shelters, health fairs, soup kitchens, and other community ‘hot spots’ where drug use, HIV and HCV are prevalent.

“The rapid HCV testing technology has been absolutely transformational for us, especially for areas like the South Bronx with a high concentration of chronic health conditions, but a low concentration of people with a primary health provider,” said Robert Cordero, Executive Director of CitiWide Harm Reduction.

CitiWide offers HCV testing seven days a week, 10 hours a day, and with a trained nurse and a full-time phlebotomist on-site, they can conduct PCR testing to confirm a patient’s positive HCV test in the same day.

The ability to provide immediate HCV test results to a population that is very transient has been a critical component to the program’s success. If an individual tests positive for HCV, they are immediately linked to care, including mental wellness programs, physical treatment and counseling – a full wraparound of services.

“Before, it used to take almost two weeks to get results, and with our transient population, it was very difficult to get our participants to come back on a certain schedule and get their results,” said Cordero. “Having the ability to provide results quickly helps close the gap in the treatment cascade. It has been a game-changer.”

As part of NYCs Department of Mental Health and Hygienes ‘Check Hep C’ program, CitiWide has also been working to help educate the community on hepatitis C, and the risk factors for contracting the disease.

“I can’t stress enough how important it is that we educate folks that this is a potentially curable disease,” said Cordero. “Since HCV can survive outside of the body better than HIV, it can be spread more easily through drug use equipment sharing – not just needles. People need to understand their risk factors and get tested.”

Since June 2012, CitiWide has conducted nearly 500 rapid HCV tests and has had 141 hepatitis C reactive results with OraQuick® HCV – a rate of nearly 30 percent. Of those who tested reactive, 139 were confirmed via PCR testing.

Of those who have tested positive, 90 have enrolled in patient navigation and intensive case management, 30 of whom are fully enrolled in care at its onsite, co-located federally qualified health center and two are in HCV treatment, virally suppressed and ready for their second stage of treatment.

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