Abstract
OBJECTIVES: Hepatitis C virus (HCV) screening rates are low in the United States and may be lower among populations experiencing social vulnerability. Little is known about these potential disparities. The current study examined HCV screening prevalence across time, spatial distribution, and social vulnerability among adults in Florida. METHODS: We used data on clinical encounters from the OneFlorida+ data repository to examine the prevalence of HCV screening among adult patients in Florida (N = 1 380 811) from August 1, 2015, through July 31, 2021, by birth cohort (1924-1944, 1945-1965, 1966-1985, and 1986-1997) and risk group (average vs high risk of HCV infection based on behavioral and medical factors). Among patients with a recorded 9-digit zip code (n = 853 965), we conducted spatial analyses, and we used the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry Social Vulnerability Index (SVI) to examine screening disparities. RESULTS: The 1945-1965 birth cohort had the highest likelihood of HCV screening (7.9% among average-risk patients and 24.2% among high-risk patients); those in the 1924-1944 birth cohort had the lowest likelihood (2.0% among average-risk patients and 8.6% among high-risk patients). High-risk patients in almost every geographic area were more likely than average-risk patients to be screened. Screening prevalence was highest in north and northeastern Florida. Among all patients, screening tended to be most likely among those with the highest socioeconomic status and with either the least or most social vulnerability. CONCLUSIONS: HCV screening rates were low in Florida across all study years and birth cohorts. Spatial and SVI analyses revealed geographic disparities by region and social vulnerability groups. Interventions are needed to support HCV elimination.