New research shows rapid-testing and low-barrier of care model provided in Supervised Consumption Sites (SCS) for people who use drugs is key to Hepatitis C elimination

South Riverdale Community Health Centre (SRCHC) has teamed up with Michael Garron Hospital (MGH) and other member organizations of East Toronto Health Partners (ETHP), the Ontario Health Team (OHT) serving East Toronto, to eliminate Hepatitis C in East Toronto.

Staff at SRCHC and researchers from MGH and University Health Network recently published the results of a study to evaluate an innovative model of care to improve Hepatitis C virus (HCV) testing and treatment uptake for people who use drugs. The study has been published in the Lancet Regional Health (Americas).

HCV infection can be cured with sufficient medical treatment. However, significant barriers to care have historically kept treatment uptake low among people who inject drugs, who represent the majority of new HCV cases in Canada.

Through the study, SRCHC successfully offered access to rapid diagnostic testing in its supervised consumption site (SCS) and an ongoing connection to nursing and peer support to initiate treatment if testing was positive.

Since its opening in 2017, SRCHC’s SCS, keepSIX, has reversed over 800 overdoses. On average, it records 675 visits per month. keepSIX is staffed by workers with lived experience of drug use and offers access to a range of primary care and social service programs, including HCV treatment and support from the Toronto Community Hep C Program (TCHCP).

“It was easy access and it was somewhere where I’ve been so I was comfortable and it was easy to get the treatment and follow up. There were lots of support workers there with me, supporting me to get through the treatment. I was aware of this place [SRCHC], I already felt comfortable so I didn’t feel nervous or anything. It’s very helpful here and they’re very respectful and have lots of after-care support to help you through it. There should be more awareness about how to get treatment and have more places to go get treatment other than the hospital,” says Billy, a study participant.

The study was conducted from August 13, 2018 to September 30, 2021 and included 124 keepSIX service users. 52% of participants tested positive for HCV and were offered immediate referral to the co-located Hep C program.

50% of these participants did not know their HCV status prior to the study, indicating the need for rapid, low-barrier testing options available to high-risk groups. Of those who tested positive, 67% were linked to care, of which 67% initiated treatment to cure HCV infection.

“People who use drugs access supervised consumptions services for a number of reasons. They care deeply about their health and wellbeing and are invested in their communities. This research is exciting because it demonstrates the success of a supportive and responsive model of community care and treatment, in large part facilitated by people who have lived with, and successfully cured, hepatitis C,” says Bernadette Lettner, Treatment Nurse with the TCHCP, SRCHC.

The study will help inform ETHP’s work in improving care related to substance use and health for adults and its goal of eliminating HCV in East Toronto.

The study will also help the OHT support the recently launched Ontario Hepatitis C Elimination Roadmap, a collaborative, multi-sector initiative led by hepatitis C experts and with contributions from government, clinicians, community and more.

“Identifying innovative, low-barrier diagnostic strategies that can quickly link clients to HCV care are a critical component of our HCV elimination efforts. To reach the targets set out by the Ontario Hepatitis C Elimination Roadmap, we need to scale programs like this and continue to invest in low-barrier diagnostics in populations at risk, including people who use drugs,” says Dr. Jeff Powis, Medical Director of Infection Prevention and Control at MGH, Medical Lead of Integrated Care at ETHP and Medical Director of Research at TCHCP.

About South Riverdale Community Health Centre

South Riverdale Community Health Centre (SRCHC) is a non-profit, multi-service organization that provides primary healthcare, social and community outreach services with an emphasis on health promotion and disease prevention primarily to people of East Toronto. As a leader in community health, SRCHC services include integrated primary health care, health promotion, harm reduction, environmental health, community food centre and population-based community programs for marginalized peoples. Health equity and inclusion are values that underpin programs and delivery of services. SRCHC is a proud member of East Toronto Health Partners, the Ontario Health Team serving East Toronto.

About Michael Garron Hospital

Nestled in the heart of East Toronto, Michael Garron Hospital (MGH) is a vibrant community teaching hospital serving more than 400,000 people in 22 distinct neighbourhoods. For more than 90 years, MGH has delivered high-quality, patient-centred healthcare services to families along the continuum of care, from welcoming a new life to facing end-of-life. MGH is a full-service hospital with strong community and research partners, including the University of Toronto. MGH is a proud member of East Toronto Health Partners, the Ontario Health Team serving East Toronto.

About East Toronto Health Partners

East Toronto Health Partners (ETHP), the Ontario Health Team (OHT) serving East Toronto, is a group of more than 100 community, primary care, home care, hospital and social services organizations in East Toronto working together to create an integrated system of care across our communities. Collectively, ETHP is responsible for providing care and support to the 300,000 individuals who live in East Toronto communities, as well as an additional 75,000 clients who choose to receive health care in the local area. Clients, family members and caregivers are partners in every aspect of the development of ETHP, working together to improve the way East Toronto residents access and receive care. Visit to learn more.

Additional Client Quotes

Jenny House-Gerow, study participant: “Prior to joining the study, I didn’t know where to turn or who to ask my questions about Hep C. Then I met the study nurse and she was the most helpful person I had ever met in my life and she walked me through it. She told me there was a test and I could get my results back in an hour. Before there was always a stigma – oh you’ve got Hep C and then whispering back and forth in the emergency department.  It was a terrible feeling. I was expecting that again. But this place was really there for me and gave me a helping hand. They gave me knowledge and options about my treatment. There are so many places without services like this – we need to expand harm reduction services. I’ve lost so many friends. People are dying from Hep C because they don’t know there’s that magic little pill that could cure them. Some places are so unaware – there is no education for the people who actively use drugs.”

Dave Valente, study participant: “It was a lot easier than I thought it was going to be. I knew I had Hep C for a long time but I never really did try to get treatment. But here, everyone else was doing it and so I thought – sure! You’ve gotta stick it in people’s faces. It’s kind of still in the background – there has to be more awareness. Knowing where to go is the main problem. It was really easy here and the people helped me out quite a bit. My health is so much better now – night and day.  I feel so much better, I feel great.”