HRSA-funded health centers play an important role in Ending the HIV Epidemic by serving as a key point of entry for people undiagnosed with HIV. Many health centers provide HIV care services, including Pre-exposure Prophylaxis (PrEP). Health centers emphasize coordinated and comprehensive care, and have the ability to manage patients with multiple health care needs. Integration of HIV testing, prevention, care, and treatment into primary care settings and providing essential enabling services such as outreach, patient education, case management, and care coordination, can increase access and improve health outcomes for patients living with HIV.
According to CDC estimates, more than 1.1 million people in the United States are living with HIV infection, and almost 1 in 7 (15%) are unaware of their infection. Many are members of vulnerable populations and underserved communities.
HRSA-funded health centers treated over 200,000 HIV positive patients in 2021 and tested 2.75 million patients.
Health centers interested in expanding HIV-related services, or improving integration of those services into primary care, may benefit from resources developed or used by other health centers.
HIV Related Technical Assistance Resources
HRSA Health Center Program: Provision of HIV Pre-exposure Prophylaxis (PrEP) in Health Centers Technical Assistance Resource (PDF - 194 KB) (2019)
HRSA Health Center Program: Provision of HIV Testing in Health Centers Technical Assistance Resource (PDF - 204 KB) (2019)
In the United States, the most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C. According to CDC estimates, 2.4 million people in the United States are living with the hepatitis C virus (HCV) and over 860,000 people are living with the hepatitis B virus (HBV, CDC, 2019). Recent outbreaks of hepatitis A, hepatitis B, and hepatitis C have been linked to the opioid epidemic through both injection and non-injection drug use (CDC, 2018). Although baby boomers (adults born between 1945-1965) have the highest prevalence of chronic hepatitis C infection, the highest incidence of new hepatitis C cases occurs among young adults aged 20-29 years.
Many individuals at risk for or living with viral hepatitis are members of vulnerable populations and underserved communities. These individuals may also be at risk for other illnesses or chronic conditions, including HIV and substance use disorder.
Health centers emphasize coordinated and comprehensive care, and the ability to manage patients with multiple health care needs. Primary care integration of viral hepatitis testing, vaccination, other prevention, care, and treatment can increase access and improve health outcomes for at-risk patients and patients with chronic infection. Health centers report data on hepatitis B and hepatitis C testing and diagnoses as part of the Uniform Data System (UDS).
In 2021, HRSA-funded health centers tested over 1.1 million patients for hepatitis B and over 1.9 million patients for hepatitis C.
Action Steps and Guidelines for Health Centers
The National Viral Hepatitis Action Plan 2021-2025 (PDF - 1 MB) details specific opportunities for health care providers, patients, and community leaders to help address viral hepatitis. Hepatitis A and hepatitis B are vaccine preventable. Viral hepatitis testing and vaccination are covered preventive services (CDC, 2016). Viral hepatitis can be a short-term illness, but hepatitis B and hepatitis C can become a long-term chronic infection.
Health centers working to improve viral hepatitis clinical quality and advance integration of hepatitis-related services into primary care may benefit from the following resources.
Screen and Understand Results
The only way to diagnose chronic viral hepatitis is blood testing. Viral hepatitis screening includes multiple tests and can be complex. These resources may help to identify which tests are most appropriate for your patient.
- The U.S. Preventive Services Task Force (USPSTF) has published recommendations to screen for hepatitis B in pregnant women as well as hepatitis B and hepatitis C in persons at high risk for infection.
- CDC provides these resources on viral hepatitis screening:
Safe and effective vaccines are available for hepatitis A and hepatitis B. These vaccines are routinely provided during the primary infant vaccination series and are recommended for vulnerable adolescents and adults as well as anyone seeking protection. There is no vaccine for hepatitis C.
- Vaccines.gov provides overall guidance on the hepatitis A vaccine and hepatitis B vaccine that includes who needs to get the vaccines and the vaccination schedules.
- CDC provides these resources on hepatitis A and hepatitis B vaccination:
Treat Disease and Manage Patients
Safe and effective treatments for hepatitis B and hepatitis C are available. These treatments have been shown to reduce the likelihood of developing cirrhosis and liver cancer. They consist of oral medications and in the case of hepatitis C, treatment can result in a virologic cure.
There are also many interventions providers can recommend for people with chronic hepatitis B and hepatitis C to stay healthy and decrease the chance of disease progression. These include reducing alcohol intake, maintaining a healthy weight, using care with over-the-counter medications, and receiving regular care including monitoring for liver cancer.
Provider Training and Resources