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Type of submission: Oral
Conference track: Practice
Topics: Innovative Harm Reduction Programmes; Viral Hepatitis and Tuberculosis
Presenting author: Zoe Dodd
Zoe Dodd, Kate Mason, Jennifer Broad, Marty Behm, Annika Ollner, Jason Altenberg, Jeff Powis
Issue: In Canada, 70% of new Hepatitis C (HCV) infections are related to injection drug use (IDU) and yet only 1-3% of HCV positive substance users receive treatment. The Toronto Community Hepatitis C Program (TCHCP) began 10 years ago to improve access to HCV treatment and care for marginalized people who use drugs/alcohol.
Setting: The TCHCP is a partnership between 3 community-based health care agencies. 88% of program clients have a lifetime history of IDU, 10% have injected in the past month and one third have used non-injection drugs (other than marijuana) in the same period.
Project: The TCHCP is based on the theories and practices of harm reduction and community development, including the meaningful involvement of people who use drugs in program design and delivery. HCV treatment is anchored on a weekly support group. Primary care physicians and nurses/nurse practitioners provide HCV treatment and care during the weekly group sessions with monthly on-site specialist support. Clients can also access case management or other one-on-one supports and referrals during weekly group sessions. Patient Advisory Board (PAB) and Community Support Worker (CSW) positions are filled by current or former program clients. The PAB provides advice regarding current and future program direction. CSWs are integrated members of the multidisciplinary care team.
Outcomes: For the past 10 years, the program has demonstrated positive HCV treatment outcomes comparable to those achieved in clinical trials and improvements in health outcomes for clients outside of their HCV. The program reduces numerous barriers to engaging people who use drugs such as past negative experiences with healthcare, social isolation, stigma, and poverty. Successful strategies utilized by the TCHCP include: harm reduction framework, group support, involvement of people with lived experience of HCV in program design and delivery, a community-based setting, and a multidisciplinary team approach.