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How colleagues can break roadblocks in hepatitis C care

People who inject drugs face significant barriers to accessing healthcare, despite the fact that: higher need levels than the general population.

Colleagues can help break down some of the stigma and discrimination barriers in the health system and give this marginalized population the care they need.

Freya Saich and Jacqui Richmond of the Burnet Institute and Amanda Kvassay and Rebecca Kavanagh of the Queensland Injectors Health Network write below about a peer support project to help people with hepatitis C get treatment and discuss the importance of ensuring that colleagues are properly trained, supported and remunerated.

Freya Saich, Jacqui Richmond, Amanda Kvassay and Rebecca Kavanagh write:

It has been recognized for some time that health services are often inaccessible, ruthless and even discriminatory for many people seeking health care, including those who inject drugs.

Indeed, findings of the Stigma Indicators Monitoring Project found that by 2021, nearly two in three health professionals reported that they would behave negatively towards other people because of their injecting drug use. Such negative interactions can prevent people from seeking the care they need, leading to complications and more serious illness.

Fighting stigma and discrimination

To combat stigma and discrimination, there is a growing movement and involvement of peers in a range of services. Mental health peers have been given a prominent role, but much less is known about peers interacting with people who inject or use drugs.

While definitions vary, we consider peers to be anyone with a lived (past) or living (current) experience of drug use.

Regardless of the definition used, peers draw on their shared experiences to connect and interact with others. Many peers understand the challenges associated with seeking healthcare and can help others prioritize their health needs, navigate the system, and provide support, and recently there has been a growing role for peers in delivering hepatitis C care.

hepatitis C. to eliminate

One example is that of QuIHN (Queensland Injectors Health Network), which received funding from the Eliminate Hepatitis C (EC) Australia partnership to deliver a peer project that aims to support people who inject drugs to gain access. to hepatitis C treatments – which can cure them of the disease. As part of the project, QuIHN employed five part-time colleagues who tested nearly 110 people using hepatitis C point-of-care testing and supported 25 people to access hepatitis C treatment.

To reach these people, QuIHN colleagues engaged with customers who participated in QuIHN’s needle and syringe programs and visited other services that customers visited. Colleagues approached clients with understanding of their situation and were able to help people address concerns about hepatitis C and available treatments.

QuIHN: Image provided by The Burnet Institute

Educating and dispelling myths

EC Australia and AIVL have also jointly designed a health promotion campaign that will be delivered by colleagues in outreach settings to connect with people who do not have access to hepatitis C treatment and/or who are disconnected from health services. For some people with hepatitis C, they may not know they have the disease (since it can be asymptomatic for years).

For others aware of their diagnosis, they may have heard stories of previous treatments causing significant side effects with low cure rates, but may not know that that is no longer the case with currently available treatments, while others may think that continuing injecting prevents them from accessing treatment. Colleagues can debunk these myths and put people in touch with the right services to get them tested and treated.

Other roles for fellow workers

In addition to outreach services, there are also roles for colleagues within the health services (both in paid and voluntary roles). For example, some needle and syringe programs employ colleagues who are trained in overdosing and supporting clients’ health needs.

There are also opportunities for fellow workers to be trained in phlebotomy, especially as some people who inject drugs have poor access to the veins or experience significant discrimination when their blood is drawn. Likewise, integrating peers into traditional or mainstream health care can also serve to reduce the stigma and discrimination experienced by many people who use drugs.

It is essential that peer employees are not only recruited to work in such roles, but that they also receive appropriate support, including supervision and management based on a peer-oriented framework, and that they receive appropriate compensation for to receive this work.

Peer workers should be supported to deal with challenging situations, should be supported to set boundaries and navigate their role as a peer worker. Without such support fellow workers can get a burnout ultimately reduce the retention of their valuable knowledge and expertise.

Peer Workforce Support

In addition, while co-workers can help reduce the stigma and discrimination customers experience, co-workers themselves can experience discrimination when they come into contact with services that are unfamiliar with co-workers and what they offer. to have.

Colleagues should be given adequate support to respond to these situations, but at the same time we need to do more to address the stigma and discrimination experienced by this community as a whole.

Image provided by The Burnet Institute

Freya Saicho
Freya Saich has spent the past seven years working in policy and advocacy, advocating for systemic reforms in the disability and health sector. Freya currently serves as a policy and research officer at the Burnet Institute and as chief policy officer at The Eliminate Hepatitis C Australia (EC Australia) Partnership. Freya works on COVID-19 and hepatitis C related projects to translate research findings to inform and influence policy and practice and to advocate for systemic change.

Jacqui Richmond
Jacqui Richmond has spent 25 years in the viral hepatitis industry in nursing, education, social and health services, and policy development roles. She currently works at the Burnet Institute as a Human Resources Development and Healthcare Project Manager for the Eliminate Hepatitis C (EC) Australia partnership. The broad focus of Jacqui’s work is building the capacity of health professionals to test, treat and manage the health care needs of people with viral hepatitis.

Amanda Kvassay
Amanda Kvassay has spent the past 6 years working for the Queensland Injectors Health Network (QuIHN) as a Program Manager for Hepatitis C Testing and Treatment Services. Amanda is a passionate advocate for equitable and accessible harm reduction services in Queensland and has spent the past 23 years working across the sector worked. She is currently working with a team of dedicated harm reduction workers, fellow workers and clinical staff to implement hepatitis C services targeting people injecting drugs.

Rebecca Kavanagh
Rebecca Kavanagh (Bec) is the Harm Reduction Coordinator for QuIHN’s Brisbane office and has been with QuIHN for 10 years. Bec has also been on the board of QuIVAA for 5 years and advocates for the rights of people who use drugs in Queensland. Bec is passionate about reducing stigma and discrimination to ensure better health outcomes for people who use drugs and the elimination of Hep C in her community.

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