{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T11:45:21Z","timestamp":1771674321215,"version":"3.50.1"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"Supplement_5","license":[{"start":{"date-parts":[[2020,9,2]],"date-time":"2020-09-02T00:00:00Z","timestamp":1599004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","award":["000513867"],"award-info":[{"award-number":["000513867"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","award":["000519267"],"award-info":[{"award-number":["000519267"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The effectiveness of hepatitis C testing and linkage-to-care (LTC) is poorly characterized in low-resource jurisdictions facing gaps in harm reduction, including illegality of syringe exchange services. Effectiveness of a community-based test\/LTC program was evaluated in Alabama.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In 2016\u20132018, shelters, drug treatment centers (DTCs), AIDS organizations, and Federally Qualified Health Centers (FQHCs) engaged in screening\/LTC. A coordinator navigated individuals to confirm viremia and link to substance use treatment or primary care with hepatitis C prescribers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Point-of-care (POC) tested 4293 individuals (10% [427] antibody-positive, 71% [299\/419] RNA performed, 80% [241\/299] viremia confirmed) and 93% linked to care (225\/241). Electronic medical record (EMR)-based reflex strategy screened 4654 (15% [679] antibody positive, 99% [670\/679] RNA performed, 64% [433\/679] viremia confirmed) and 85% linked to care (368\/433). We observed higher odds of RNA confirmation in EMR-based reflex versus POC (OR, 2.07; P\u2005&amp;lt;\u2005.0001) and higher odds of LTC in EMR-based reflex versus POC (OR, 1.51; P\u2005&amp;lt;\u2005.0001). Overall, 53% individuals tested were nonbaby boomers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In Alabama, screening at high-risk settings identified significant hepatitis C burden and reflex testing outperformed point-of-care linkage indicators. Colocating testing in DTCs and treatment in FQHCs provided key LTC venues to at-risk younger groups.<\/jats:p><\/jats:sec>","DOI":"10.1093\/infdis\/jiaa207","type":"journal-article","created":{"date-parts":[[2020,4,22]],"date-time":"2020-04-22T03:20:31Z","timestamp":1587525631000},"page":"S365-S375","source":"Crossref","is-referenced-by-count":9,"title":["Hepatitis C Among High-Risk Alabamians: Disease Burden and Screening Effectiveness"],"prefix":"10.1093","volume":"222","author":[{"given":"Anthony B","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Karumberia","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Gilmore","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebony","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nichole","family":"Bruner","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgar Turner","family":"Overton","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael S","family":"Saag","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7655-4809","authenticated-orcid":false,"given":"Ricardo A","family":"Franco","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,9,2]]},"reference":[{"key":"2020090213233162500_CIT0001","doi-asserted-by":"crossref","first-page":"293","DOI":"10.7326\/M13-1133","article-title":"Chronic hepatitis C virus infection in the United States, National Health and Nutrition 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