People who are incarcerated experience a high rate of hepatitis C (HCV) worldwide, and HCV micro-elimination in prisons is an effective strategy to support treatment. In Victoria, British Columbia, administrative barriers limited HCV testing and treatment at Vancouver Island Correctional Centre (VIRCC), and people who were HCV RNA+ were lost to follow up. Cool Aid Community Health Centre (CACHC) is an inner-city, primary care clinic that serves a marginalized population. The CACHC HCV nurse coordinator with the VIRCC nurse held HCV testing ‘blitzes’ at VIRCC and offered phlebotomy for screening and pre-treatment bloodwork. Clients who tested HCV RNA+ were started on HCV treatment and if discharged before completion, CACHC followed them in the community. A retrospective chart review was conducted to identify all clients who accessed HCV testing and treatment through the VIRCC partnership. To date, 230 clients were tested: 49 tested HCV antibody+, 11 tested HCV RNA+, and 10 started on treatment (6 SVR). Case management and consultation with the nurse coordinator and VIRCC nurse supported treatment starts for an additional 18 clients (14 SVR). This pragmatic and innovative approach to HCV care with people who are incarcerated demonstrated effective HCV testing and treatment. CACHC and VIRCC have established closer relationships and reduced barriers to reach and maintain continuity with this target population.

Background: HIV prevalence among cis and trans women is increasing, yet prevention medication uptake remains low. Despite extensive literature regarding pre-exposure prophylaxis (PrEP), less is known about post-exposure interventions for women. Among women, non-occupational post-exposure prophylaxis (PEP) is mainly used in sexual assault centres and rarely otherwise. PEP-in-Pocket (PIP) is a self-initiated PEP option for infrequent high-risk exposures (<4/year) and could offer women more agency over their sexual health. PIP, an evolution of PEP endorsed by international guidelines, may better address women’s diverse needs, yet remains understudied and underutilized. Objective: To develop a clear contextual understanding of PEP and PIP in the context of women based on its current use in the literature. Design: Rodgers’ Evolutionary Concept Analysis. Rodger’s methodology is a flexible, non-linear approach suited for evolving health concepts and involves three phases: conceptualizing the concept; identifying key attributes, antecedents, and consequences; and interpreting findings to inform future research. Data sources: Scholarly peer-reviewed literature. Methods: A systematic search (January 2012-May 2025) across Medline, Emcare, and Global Health identified 33 relevant studies. Two reviewers screened and extracted texts using Covidence. Rodgers’ evolutionary concept analysis was used to examine PEP and PIP among cis and trans women. Results: PEP attributes include reactive use after exposure, clinical initiation, and time-sensitive access. Key attributes of PIP include self-initiation, episodic use, autonomy, and accessibility outside healthcare settings. Shared antecedents include barriers to access, and the need for alternative HIV prevention strategies. PIP-specific antecedents include infrequent high-risk exposures and a desire for greater individual control, especially among those who may not interact with healthcare providers. Consequences of both strategies include reduced HIV risk and expanded options. Overall, the literature on PIP was limited, but increased agency, empowerment, and potential to fill HIV prevention gaps were noted. Conclusions: PEP and PIP are promising, women-centered HIV prevention strategies that support autonomy and timely care but remain underutilized. This analysis identifies significant gaps in research and implementation for women, underscoring the need for further investigation to advance equitable HIV prevention.