ABSTRACT Background: Birth cohort hepatitis C Virus (HCV) screening recommendations were issued by the Centers for Disease Control and Prevention (CDC) and United States Preventive Services Task Force (USPSTF) in 2012 and 2013, respectively. Despite this, studies have reported low HCV screening rates. Currently, the prevalence of HCV screening rates …
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ABSTRACT Background: Birth cohort hepatitis C Virus (HCV) screening recommendations were issued by the Centers for Disease Control and Prevention (CDC) and United States Preventive Services Task Force (USPSTF) in 2012 and 2013, respectively. Despite this, studies have reported low HCV screening rates. Currently, the prevalence of HCV screening rates nationally is unknown and there are no in-depth studies that have evaluated the barriers or facilitators of HCV screening. Our study aimed to fill this gap by 1) conducting a systematic literature review to assess the national HCV screening prevalence, 2) evaluating temporal trends in HCV screening using a large academic center, and 3) identifying barriers and facilitators associated with HCV screening among average-risk baby boomers using geographical information system (GIS) analyses to assess spatial autocorrelation hot spots and cold spots for HCV screening by individual and population-based characteristics. Methods: To accomplish our aims, 1) a systematic literature review was conducted using controlled vocabulary to ascertain the HCV screening prevalence in the U.S. by limiting our search to articles published between January 1, 2012 and March 14, 2019 to coincide with 2012 and 2013 CDC and USPSTF guidelines, respectively for one-time universal testing for HCV among baby boomers (adults born 1945–1965), 2) temporal analyses were conducted covering August 1, 2015 to July 31, 2019 time period for average-risk baby boomers using CochraneArmitage test for trend analysis and Joinpoint analysis, and 3) geospatial analyses using geographic information systems’ software were conducted to a) create choropleth maps for HCVof those orders, only 4,259 HCV antibody tests were completed by average-risk baby boomers. The trend by month for HCV ordering percentages of HCV antibody tests during this period of time and showed that the lowest HCV antibody order rate of 1.0% (95% confidence interval [CI]: 0.5%–1.4%) occurred in August 2015. In contrast, the highest HCV antibody order rate of 12.7% (95% CI: 11.4%–14.0%) occurred in May 2017. And by the end of the study period, the HCV antibody order rate was 4.2%. At the start of the period, the HCV screening percentage (HCV antibody test completion) was 0.6% (95% CI: 0.0%–0.9%) in August 2015, at its peak in May 2017, the HCV screening percentage reached 8.8% (95% CI: 7.6%–9.9%), and by the end of the study period, the HCV screening percentage declined to 2.1% (95% CI: 3.1%–2.6%) by July 2019. For Aim 3, spatial autocorrelation showed statistically significant clustering of HCV antibody test orders (GMI = 0.541096; p
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