The DePASS initiative in healthcare access units: Do not miss the opportunity to detect HIV, HBV, and HCV

This is the authors' abstract. We don't add key points for this paper.

OBJECTIVES: HIV, HBV, and HCV infections remain major public health concerns, particularly among vulnerable populations. Free-of-charge healthcare units provide essential care for individuals facing barriers to healthcare. However, systematic testing remains inconsistent. The DePASS initiative aimed to promote routine screening, assess infection seroprevalences, and identify barriers and facilitators to implementation. METHODS: This multicenter prospective observational study was conducted in 12 free-of-charge healthcare units across mainland France. Staff received training on HIV/HBV/HCV screening. Over a 9-month period, units offered HIV/HBV/HCV testing to all attendees, with HDV testing for HBV-positive individuals. Diagnoses and linkage to care were quantitatively assessed. A qualitative survey explored feasibility, acceptability, and perceived barriers among staff. RESULTS: Between December 2022 and May 2024, 6602 individuals were tested. Seroprevalence was 1.76% for HIV, 2.32% for HCV, and 5.76% for HBV; 6.53% of HBV-positive individuals also tested positive for HDV. Among those with HIV, 90.4% were linked to care. Staff cited logistical constraints, limited time, and language barriers as major challenges. CONCLUSIONS: Systematic HIV/HBV/HCV testing yielded diagnosis rates 7 to 9 times higher than those estimated in the general French population. Scaling up this model, combined with staff training and structural support, could substantially reduce undiagnosed infections in vulnerable people.