Date of Award

Spring 5-17-2019

Degree Type

Capstone Project

Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Ashli Owen-Smith

Second Advisor

Kim Ramsey-White


INTRODUCTION The CDC recommends one-time HCV screening of all baby boomers and those at high risk for infection. Despite HCV being the most common blood-borne virus in the US, routine HCV testing is not uniformly practiced.

AIM To evaluate the prevalence of HIV/HCV screening prior to and following the implementation of a dual routine opt-out program, the linkage to care practices for positive patients, and the demographic characteristics of positive patients in a southern FQHC.

METHODSWe conducted a retrospective, cross-sectional study using electronic health record data from patients receiving care at SMC in Atlanta.

RESULTS Pre-implementation: Of the 68 HIV+ patients, most were linked to care (97.05%), African American (95.59%), non-Hispanic (98.53%), and male (62.50%). Of the 89 HCV+ patients, most were African American (67.42%), non-Hispanic (97.75%), male (53.93%), and baby boomers (72.02%). There were 3 co-infected patients.Post-implementation: Of the 232 HIV+ patients most were African American (82.33%), non-Hispanic (93.53%), and male (58.19%). The linkage to care rate was 96.98%. Of the 274 HCV+ patients, 52.92% were African American, 94.89% were non-Hispanic, 55.84% were male, 79.71% were linked to care, and 77.38% were baby boomers. There were 13 co-infected patients.

DISCUSSION These results reflect the population SMC serves: non-Hispanic African Americans.The age distribution of the HCV+ patients matched the trends seen nationwide for the 1945-1965 birth cohort. There was a 286% increase for HIV tests. The increase in HIV/HCV testing and high linkage to care rates may partly be due to the hiring of an Infectious Disease specialist in 2015.