{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:52:19Z","timestamp":1784202739102,"version":"3.55.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":41,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["GH20-2130"],"award-info":[{"award-number":["GH20-2130"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["EUGEO2219881"],"award-info":[{"award-number":["EUGEO2219881"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Scaling up hepatitis C virus (HCV) testing and diagnosis is a critical goal of the Global WHO elimination strategy. HCV self-testing (HCVST) has emerged as a promising self-care approach to improve access and early detection, particularly among hard-to-reach populations. In Georgia, a 2015 HCV serosurvey indicated that 57.3% of anti-HCV reactive individuals were men aged 30\u201359. This study evaluated a secondary distribution strategy for HCVST aimed at increasing testing uptake among this population in Tbilisi, Georgia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We implemented an observational cross-sectional study evaluating a secondary distribution delivery model of HCVST. We recruited women attending three cancer screening centers. Women who reported having a male family member or partner aged 30\u201359\u00a0years who had not previously been tested for HCV were provided with 1\u20133 oral fluid HCVST kits to distribute to these men, who were encouraged to complete the test, upload results to an online platform, and complete a questionnaire capturing demographic and risk-related data. Univariate and bivariate analyses were conducted to assess factors associated with reactive HCVST results. Linkage to care was evaluated via the national hepatitis C elimination program database six months after testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between June 2022 and March 2023, 1,859 women were enrolled, distributing 2,744 kits. A total of 852 men uploaded test results; 723 (84.9%) completed the questionnaire. Of these, 16 (1.9%) reported a reactive result, 807 (94.7%) were non-reactive, and 29 (3.3%) indeterminate. Prior HCV testing was reported by 10.3% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200988). Reactive results were significantly associated with a history of imprisonment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.01) and injection drug use (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.02). Of the 16 with reactive results, 10 were tested to confirm results at medical facilities, and 9 cases confirmed positive for anti-HCV. Seven (78%) were RNA-positive and initiated treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Secondary distribution of HCVST kits through women effectively engaged previously untested men and demonstrated a high rate of follow-up and treatment initiation. This strategy offers a promising model for expanding HCV testing coverage in Georgia. However, strengthened linkage-to-care mechanisms are essential to ensure timely confirmation and treatment of HCV infections identified through self-testing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-026-26439-9","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T06:56:22Z","timestamp":1775026582000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Results of the HCV self-testing implementation study through the secondary distribution of HCV self-tests among adult males in Georgia"],"prefix":"10.1186","volume":"26","author":[{"given":"Ketevan","family":"Stvilia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rania A.","family":"Tohme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonjelle","family":"Shilton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maia","family":"Tsereteli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketevan","family":"Galdavadze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senad","family":"Handanagi\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina Tskhomelidze","family":"Schumacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun","family":"Shadaker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eter","family":"Kiguradze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar","family":"Skhirtladze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antons","family":"Mozalevskis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas","family":"Luhmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"26439_CR1","unstructured":"Global hepatitis report 2024: action for access in low- and middle-income countries. Geneva: World Health Organization; 2024. Licence: CC BY-NC-SA 3.0 IGO."},{"key":"26439_CR2","unstructured":"World Health Organization, Global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022\u20132030, 18 Jul, 2022, World Health Organization: Geneva. https:\/\/www.who.int\/publications\/i\/item\/9789240053779."},{"key":"26439_CR3","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.15585\/mmwr.mm6541a2","volume":"65","author":"L Gvinjilia","year":"2016","unstructured":"Gvinjilia L, Nasrullah M, Sergeenko D, et al. National progress toward hepatitis C elimination \u2014 Georgia, 2015\u20132016. MMWR Morb Mortal Wkly Rep. 2016;65:1132\u20135.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"26439_CR4","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1007\/s11524-006-9032-y","volume":"83","author":"K Stvilia","year":"2006","unstructured":"Stvilia K, Tsertsvadze T, Sharvadze L, et al. Prevalence of hepatitis C, HIV, and risk behaviors for blood-borne infections: a population-based survey of the adult population of T\u2019bilisi, Republic of Georgia. J Urban Health. 2006;83:289\u201398.","journal-title":"J Urban Health"},{"issue":"6","key":"26439_CR5","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1093\/infdis\/jiad064","volume":"228","author":"A Gamkrelidze","year":"2023","unstructured":"Gamkrelidze A, Shadaker S, Tsereteli M, Alkhazashvili M, Chitadze N, Tskhomelidze I, et al. Nationwide hepatitis C serosurvey and progress towards hepatitis C virus elimination in the country of Georgia, 2021. J Infect Dis. 2023;228(6):684\u201393. https:\/\/doi.org\/10.1093\/infdis\/jiad064.","journal-title":"J Infect Dis"},{"issue":"28","key":"26439_CR6","doi-asserted-by":"publisher","first-page":"753","DOI":"10.15585\/mmwr.mm6428a2","volume":"64","author":"K Mitruka","year":"2015","unstructured":"Mitruka K, Tsertsvadze T, Butsashvili M, Gamkrelidze A, Sabelashvili P, Adamia E, et al. Launch of a Nationwide Hepatitis C Elimination Program \u2014 Georgia, April 2015. Morb Mortal Wkly Rep. 2015;64(28):753\u20137 (Cited 2021 May 4).","journal-title":"Morb Mortal Wkly Rep."},{"key":"26439_CR7","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1111\/jvh.13119","volume":"26","author":"AH Litwin","year":"2019","unstructured":"Litwin AH, Drolet M, Nwankwo C, Torrens M, Kastelic A, Walcher S, et al. Perceived barriers related to testing, management and treatment of HCV infection among physicians prescribing opioid agonist therapy: the C-SCOPE study. J Viral Hepat. 2019;26:1094\u2013104. https:\/\/doi.org\/10.1111\/jvh.13119.","journal-title":"J Viral Hepat"},{"key":"26439_CR8","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s13011-022-00438-6","volume":"17","author":"M Butsashvili","year":"2022","unstructured":"Butsashvili M, Abzianidze T, Kamkamidze G, et al. Barriers of linkage to HCV viremia testing among people who inject drugs in Georgia. Subst Abuse Treat Prev Policy. 2022;17:23. https:\/\/doi.org\/10.1186\/s13011-022-00438-6.","journal-title":"Subst Abuse Treat Prev Policy"},{"key":"26439_CR9","unstructured":"Recommendations and guidance on hepatitis C virus self-testing. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO."},{"key":"26439_CR10","unstructured":"OraSure Technologies. OraQuick HCV Rapid Antibody Test. Available: https:\/\/www.orasure.com\/products-infectious\/OraQuick-HCV.html. Accessed 14 July 2024."},{"issue":"1","key":"26439_CR11","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-020-01835-z","volume":"18","author":"TC Witzel","year":"2020","unstructured":"Witzel TC, Eshun-Wilson I, Jamil MS, Tilouche N, Figueroa C, Johnson CC, et al. Comparing the effects of HIV self-testing to standard HIV testing for key populations: a systematic review and meta-analysis. BMC Med. 2020;18(1):381.","journal-title":"BMC Med"},{"key":"26439_CR12","unstructured":"Fonner VA, Kautsar H, Eshun-Wilson I, et al. Hepatitis C virus self-testing: systematic review report. In: Recommendations and guidance on hepatitis C virus self-testing. Geneva: World Health Organization; 2021 Jul. Web Annex C. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK572750\/."},{"issue":"1","key":"26439_CR13","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-022-07484-2","volume":"22","author":"E Fajardo","year":"2022","unstructured":"Fajardo E, Watson V, Kumwenda M, Usharidze D, Gogochashvili S, Kakhaberi D, et al. Usability and acceptability of oral-based HCV self-testing among key populations: a mixed-methods evaluation in Tbilisi, Georgia. BMC Infect Dis. 2022;22(1):510. https:\/\/doi.org\/10.1186\/s12879-022-07484-2.","journal-title":"BMC Infect Dis"},{"key":"26439_CR14","unstructured":"Reipold EI, Van Nguyen TT, Shiha G, Stvilia K, Monroe-Wise A, Wang C, et al. Hepatitis C virus self-testing: multi-country evidence on usability and acceptability Conference on Retroviruses and Opportunistic Infections, Boston, March 6\u201310, 2021. https:\/\/www.natap.org\/2021\/CROI\/croi_129.htm."},{"key":"26439_CR15","doi-asserted-by":"crossref","unstructured":"Reipold EI, Farahat A, Elbeeh A, Soliman R, Aza EB, Jamil M, et al. Usability and acceptability of self-testing for hepatitis C virus infection among the general population in the Nile Delta Region of Egypt. Research Square; 2021.","DOI":"10.21203\/rs.3.rs-155389\/v1"},{"key":"26439_CR16","doi-asserted-by":"publisher","first-page":"792","DOI":"10.3855\/jidc.20658","volume":"19","author":"M Butsashvili","year":"2025","unstructured":"Butsashvili M, Kanchelashvili G, Galdavadze K, Tsereteli M, Baliashvili D, Handanagic S, et al. Risk factors for HCV infection in Georgia: a case-control study. 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Partner-delivered HIV self-test kits with and without financial incentives in antenatal care and index patients with HIV in Malawi: a three-arm, cluster-randomised controlled trial. Lancet Glob Health. 2021;9:e977\u201388.","journal-title":"Lancet Glob Health"},{"issue":"4","key":"26439_CR21","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1097\/QAI.0000000000002344","volume":"84","author":"B Hensen","year":"2020","unstructured":"Hensen B, Schaap AJ, Mulubwa C, Floyd S, Shanaube K, Phiri MM, et al. Who accepts and who uses community-based secondary distribution HIV Self-Testing (HIVST) kits? findings from the intervention arm of a cluster-randomized trial of HIVST distribution nested in four HPTN 071 (PopART) communities in Zambia. J Acquir Immune Defic Syndr. 2020;84(4):355\u201364.","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"11","key":"26439_CR22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002166","volume":"13","author":"SH Masters","year":"2016","unstructured":"Masters SH, Agot K, Obonyo B, Napierala Mavedzenge S, Maman S, Thirumurthy H. Promoting partner testing and couples testing through secondary distribution of HIV self-tests: a randomized clinical trial. PLoS Med. 2016;13(11):e1002166.","journal-title":"PLoS Med"},{"issue":"5","key":"26439_CR23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003608","volume":"18","author":"PP Indravudh","year":"2021","unstructured":"Indravudh PP, Fielding K, Kumwenda MK, Nzawa R, Chilongosi R, Desmond N, et al. Effect of community-led delivery of HIV self-testing on HIV testing and antiretroviral therapy initiation in Malawi: a cluster-randomised trial. 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This has been corrected.","order":8,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 July 2026","order":9,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":10,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":11,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1186\/s12889-026-27971-4","URL":"https:\/\/doi.org\/10.1186\/s12889-026-27971-4","order":12,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was conducted in compliance with the principles of the Declaration of Helsinki on Medical Research involving human subjects [\n                      \n                      ]. Ethical approval of the study protocol was obtained from both local and international ethics review boards. Locally it was obtained from the NCDC and Public Health Georgia Institutional Review Board (IRB# 2021\u2013049). Protocol version 1.1; 14 July 2021). International ethics clearance was received from the World Health Organization Ethics Review Committee (WHO ERC, Protocol ID: ERC.0003686). The US Centers for Disease Control and Prevention (CDC) reviewed the study protocol and determined CDC\u2019s role did not constitute human subjects research.Consent to participate was obtained from all study subjects.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1533"}}