Veterans Affairs Pharmacists Tests Homeless Veterans for Hepatitis C


Outreach efforts seek to address rates of undiagnosed hepatitis C virus among homeless veterans.

Health experts have recommended that all Baby Boomers get tested for hepatitis C virus (HCV) and begin treatment if diagnosed with the condition. The Department of Veterans Affairs (VA) also recommends that veterans receive testing; however, some veterans may not receive testing due to homelessness.

A clinical pharmacist at a VA hospital understood that HCV can be serious if left untreated and that it can easily be cured, according to a press release from the VA.

Instead of risking homeless veterans not receiving HCV testing, VA pharmacist Jennifer Siilata, PharmD, brought the tests to the veterans in Fresno, California.

“For a number of reasons, our homeless veteran population was not being tested,” Siilata said in the release, “mostly because of things like transportation issues, mental health concerns and drug use.”

Siilata, along with the VA Central California Health Care System, implemented a strategy to find homeless veterans, discuss how HCV can affect them, and test the patients with the goal of offering treatment, according to the release.

“It only made sense. It’s one of the only viruses that’s 100% curable, and the VA pays for all our veterans to be tested and treated,” Siilata said.

After the program was approved by the VA, a small team of pharmacy services employees began searching for homeless veterans. The team also worked with local homeless organizations and VA social services to locate the individuals, according to the article.

“We knew the numbers were high,” Siilata said. “It is estimated that about 40% of homeless people in the US are Hep C positive, and our data suggests that here in Fresno [California] and across the Central Valley, about 29% of the homeless veterans are infected with the Hep C virus.”

The team asks homeless persons if they are veterans and if they would like to be tested for HCV, according to the VA. The hope is that the program will result in a higher rate of testing and treatment for HCV among this population.

“It’s really about caring and compassion,” Siilata said. “We bring water to hand out, hygiene kits to give to them, anything we think they might need. We talk with them, take their questions, get to know them and help with their needs.”

The pharmacists have found that a majority of veterans know about HCV due to friends dying from the infection of HCV-related cancer. This suggests that they understand the seriousness of the condition, but have issues accessing care.

Thus far, approximately 25% of homeless veterans traveled back with the pharmacists to receive HCV testing, according to the release.

Next, Siilata wants to take a mobile clinic to conduct HCV testing on the spot, which may increase the testing rate since veterans do not have to travel to the hospital. Eventually, the team may expand their reach to other homeless veterans in California, according to the article.

“She has done some amazing work in conjunction with our social services team and other organizations,” said Wafa Samara, PharmD, chief of Pharmacy at the VA Central California Health Care System. “Thanks to her, our team has unofficially adopted the motto: ‘If they won’t come to us, we’ll come to them.’”

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