The hustle never stops: Eliminating hep C in Australia
Thursday, 19 September, 2024.
NUAA’s Peers on Wheels team with local partners at Hunter Homeless Connect Day, 21 August 2024.
Australia is doing relatively well in the World Health Organisation’s campaign to eliminate Hepatitis C globally by 2030. In NSW, NUAA (the organisation that publishes Users News) has played a significant role in this progress. Promoting the health of people who use drugs is one of the main reasons NUAA exists.
Hepatitis C is a blood-borne virus spread by the transfer of blood. It’s most commonly associated with injecting drug use but you can also get it from unsterilised tattoo, piercing and cosmetic equipment.
Left untreated, hep C can lead to life-threatening conditions like liver cancer and sclerosis. Even if it doesn’t, it leads to chronic ill-health that gets worse over the years.
The lack of access to safe injecting equipment in jails is one reason why, despite initial rapid progress, hep C continues to circulate in the community, and why efforts need to be ongoing.
NUAA’s work around hep C includes prevention with a Needle and Syring Program and mail-order NSP service, which supplies injecting equipment with no cost, no risk and no stigma. We also provide information, education and training on safer injection practices.
Key to eliminating hep C is wide-reaching testing and treatment for people who test positive. Testing is very important because the symptoms of hep C are often mild to begin with. They get worse slowly over time and a lot of the symptoms — things like mild to severe tiredness, loss of appetite, increased moodiness and depression, and joint pain — are the sort of symptoms that could be caused by a lot of things. So it’s easy to have hep C without knowing it.
At NUAA’s Surry Hills NSP (345 Crown Street), hep C testing happens between midday and 3pm, Tuesdays to Fridays. There are 2 types of test are available and the service user gets to choose, not the staff! Both tests involve just a finger prick of blood.
The living or lived experience of the NUAA’s workers means they know how to find a vein and they can talk and answer questions in a way that is meaningful, relatable and believable to other people who inject or have injected drugs. This is important because people who inject drugs have usually experienced stigma from healthcare services at some time, including feeling disrespected and having health needs ignored. Injecting drug users will often have experienced being “pin cushioned” and NUAA’s staff know why this makes people wary of getting any blood test for anything.
When people test positive they are encouraged to get treatment and are offered assistance and support in accessing it. Getting treatment is, of course, voluntary but it is always worth pointing out that hep C treatment has advanced a lot since Interferon with its horrible side-effects. The treatment used now (“direct acting antivirals” or DAAs) involves taking pills for a couple of months, with few or no side effects. And this treatment has a 97% success rate!
To eliminate hep C it is not enough to wait for people to come in and get tested. So NUAA's Peers on Wheels team regularly take to the road in a van with a Point of Care Testing machine and everything else needed to test for hep C.
Over the past month Peers on Wheels was in the Hunter region, attending Hunter Homeless Connect Day. Working with Hunter New England Local Health District (HNELHD), HIV and Related Programs (HARP), Newcastle NSP and the Pacific Clinic, they tested 58 people. At a follow up event with HNELHD at Hamilton South Community Centre where 39 people got tests.
NUAA also has a network of peer educators and distributors. As well as distributing education and equipment, helping to prevent hep C transmission, many have been trained to give hep C tests, and are doing so in communities throughout NSW.
Prisons are now the main location of hep C transmission in NSW, so NUAA, in partnership with Justice Health, has been conducting hep C testing and education inside jails, as well as producing harm reduction resources and the publication of Insiders News, which all provide information on how to use inside more safely and minimise the spread of hep C. However, education and testing can only achieve so much while accessing safe injecting equipment is not possible in jails. This is why allowing NSP’s in jails is one of the commonsense law reforms that NUAA advocates for.