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Type of submission: Oral
Conference track: Practice
Topics: Viral Hepatitis and Tuberculosis
Presenting author: Mary Harrod
Mary Harrod, Phillip Read, Marianne Jauncey, Ingrid Van Beek
In 2016 the Australian Government implemented unrestricted access to direct-acting antivirals (DAAs). Uptake has been strong with 26,000 people treated within five months. A focus on equity in New South Wales has seen representatives of drug user organisations involved in policy development and implementation and initiatives aimed at increasing access to marginalised people, including people who inject drugs or are on pharmacotherapy.
Inner city Sydney’s key harm reduction services include a peer-based drug user organisation (NUAA), a low threshold walk-in primary health care clinic targeted at marginalised people (KRC) and a supervised injecting facility (MSIC). These services work co-operatively with flexible referral structures to increase access to HCV treatment for highly marginalised and vulnerable individuals. Key initiatives include provision of a portable fibroscan to assess people free-of-charge at drop-in outreach clinics including the MSIC and the peer NSP with treatment initiation and monitoring provided by KRC.
Ensuring universal access to HCV treatment is challenging and requires reorientation of health services and strong clinical-community partnerships. For people living with chronic HCV, particularly those who are current drug users, the opportunity to be cured, and the government investment in their health, has led to a shift in perceptions of and engagement with health care. Peer support has been crucial to increasing access.
Outcomes include 684 fibroscan assessments in low -threshold services (388 at KRC, 80 at NUAA, 58 at MSIC and 155 other) and over 100 people who inject drugs commencing DAA treatment. Universal access has made HCV elimination a realistic goal in Australia. A continued focus on prevention, treating people where they are and peer support will be needed to sustain early successes. HCV treatment has increased engagement with health care and is a once-in-a-lifetime opportunity to benefit the community of people who use drugs.