# Unlocking Access to HCV Testing in Jail: Stakeholder Involvement in Research Is the Missing Key

> **NIH AHRQ K08** · TUFTS MEDICAL CENTER · 2021 · $150,177

## Abstract

Project Summary/Abstract
 About 3 million people in the US are living with hepatitis C virus infection (HCV), and the
burden of HCV is highly concentrated in incarcerated populations. Curative HCV treatment is
available, but infrequently available in corrections settings. There are disparities in access to
HCV care between White and Non-White people in the community, and non-White people have
higher rates of incarceration. As a result, liver disease is one of the leading causes of death in
inmates, especially Non-White inmates.
 One feasible approach to overcoming health disparities for HCV care in incarcerated
populations is increasing the diagnosis of HCV. This approach is particularly pragmatic for the
jailed population—people incarcerated for less than 2.5 years—with linkage to HCV treatment
arranged post-release. Opt-out infectious disease testing both increases overall frequency of
testing and decreases racial disparities in testing. Unlike opt-in testing, which requires explicit
agreement to perform testing, opt-out testing informs individuals that they will be tested unless
they decline. Opt-out HCV testing in prisons is recommended by federal policy, and recently
mandated in all Massachusetts (MA) prisons through a court ruling. Opt-out testing is not
mandated in MA jails.
 The overarching goal of my research proposal is improving access to HCV testing in jails
with the ultimate aim of reducing the prevalence of HCV in the US. The first aim of this research
proposal is a comparison of current HCV testing practices to testing policy through retrospective
chart review with a focus on racial disparities in access to testing. The second aim is a hybrid
effectiveness-implementation aim with the goal of implementing opt-out HCV testing and
evaluating effectiveness of opt-out testing to increase testing frequency and decrease racial
disparities in HCV testing. Imbedded in the research activities is a robust training plan including
advanced epidemiology and implementation science methodology. Support of key stakeholders
has been confirmed, including representatives from the criminal justice system, health care
providers in the jail, and the MA public health department. Augmented by training in innovative
and synergistic methodologic disciplines, completion of this research proposal will be the
foundation for a successful research career devoted to using implementation science
methodology to improve the quality and equity of health care provided in corrections settings.

## Key facts

- **NIH application ID:** 10112951
- **Project number:** 5K08HS026008-02
- **Recipient organization:** TUFTS MEDICAL CENTER
- **Principal Investigator:** Alysse Gail Wurcel
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $150,177
- **Award type:** 5
- **Project period:** 2020-05-01 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10112951

## Citation

> US National Institutes of Health, RePORTER application 10112951, Unlocking Access to HCV Testing in Jail: Stakeholder Involvement in Research Is the Missing Key (5K08HS026008-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10112951. Licensed CC0.

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