The Champion Professional: Issue 68

This issue:

1. National Hepatitis Strategies released
2. Get Bloody Serious goes north!
3. Cycle to End the Cycle in Maroubra

National Hepatitis Strategies released

The Australian Government recently released the Fifth National Hepatitis C Strategy and Third National Hepatitis B Strategy, both to run for 2018–2022. We provide here a snapshot of, and comments on, the Hepatitis C Strategy. Our January 2019 edition of The Champion will carry an overview of the very welcome Third National Hepatitis B Strategy.

The Fifth National Hepatitis C Strategy includes guiding principles to “support a high-quality, evidence-based and equitable response to hepatitis C”. Significantly, the document acknowledges the need for “ongoing and meaningful participation of people living with hepatitis C and affected communities in all aspects of the response”.

Here is a brief summary of a number of key issues raised, along with some general observations:

• SVR testing: more needs to be done to ensure people are getting SVR tested at 12 weeks post-treatment so as to confirm cure.
• Goals: The Strategy aims to decrease incidence of hep C by 60% by 2022, however it should be noted the goals of a 50% reduction in the last Strategy were not met. Hepatitis NSW believes a six monthly check of hep C status among certain priority populations might make a real difference to prevention and early cure.
• Community-led response: There are several mentions in the guiding principles of the strategy about “active” and “meaningful” participation of priority populations in “all aspects of the response.”
• Antibody vs HCV RNA/PCR testing: The Strategy talks about working towards addressing the “legal, regulatory, and policy barriers which affect priority populations and influence their health-seeking behaviours.” Hepatitis NSW believes ending antibody testing may help reduce stigma, provide faster access to healthcare, address barriers to treatment and other issues. Instead, PCR or HCV RNA testing should be the test that is used for notifications within the public health system.
• Access and equity: There were many points relating to addressing systemic, structural issues in an equitable manner.
• Evidence-based approach: There were numerous mentions of the need for evidence-based research and science informing the hep C response.
• Diagnosis: the aim for 2022 is 90% of people living with hep C diagnosed. We’re at 80% at present.
• 65% treated: The target for the percentage of people living with hep C getting treated is 65% by 2022. We’re at 25% now however our current treatment uptake at around 1,200 people per month will still leave us tens of thousands of people short of that goal.
• General community awareness: One of the priority areas listed is improving knowledge in the general community.
• Reinfection: while this is mentioned several times there’s still a limited amount of information available about reinfection. As noted above, six monthly testing of HCV among some priority populations might help.
• Gender, sex work, intersectionality: The Strategy talks about groups that are not specifically priority populations but are represented among priority populations.
     “Women with hepatitis C have… specialised needs related to their reproductive and sexual health…”
     “Sex workers face unique challenges, including structural barriers, widespread stigma and discrimination…”
• Priority settings: The Strategy mentions both priority populations and priority settings. This includes geographic locations with higher incidence or prevalence of hep C – for example, services that support priority populations, custodial settings, AMSs, NSPs, and “places where priority populations live, work and socialise.”
• PWID/ PWPID: The priority population breakdown in the Strategy splits, for the first time, ‘people who inject drugs’ and ‘people who previously injected drugs.’
• Medically acquired hep C: The Strategy uses the term “people living with medically acquired hepatitis C” as a descriptor for those who acquired hep C prior to 1990 through the health system.
• NSPs in prison: The Strategy takes a position essentially (but not directly) supporting the call for NSPs in prison. There’s also a mention of “gaps” in access to drug treatment programs in prison.
• Peers: Some mention of the importance of peer work and peer led responses.

And lastly, one of the priority areas states “facilitate a highly skilled multidisciplinary workforce that is respectful of and responsive to the needs of people at risk of or living with hepatitis C” which Hepatitis NSW fully supports.

• The 5th National Hepatitis C Strategy can be downloaded online >>>CLICK HERE
• The 3rd National Hepatitis B Strategy can be downloaded online >>>CLICK HERE

Get Bloody Serious goes north!

Northern NSW and Kempsey hosted the last series of our professional development workshop – Get Bloody Serious – for 2018. Traveling hundreds of kilometers up and down the coast we delivered hep C workshops across three Local Health Districts, including with the Justice Health & Forensic Mental Health Network (JH&FMHN).

The sessions were planned and delivered in close collaboration with NADA, the local HARP units, Liver Clinics, and the Mid North Coast Correctional Centre (MNCCC). Strong partnerships ensure great networking for people while providing a solid update on new treatments, linking in local clinical options and relevant community services.

The Mid North Coast heads the NSW LHD Scorecard within the state’s aim to eliminate hep C by 2028 with 39% of its population living with hep C initiating treatment and curing hepatitis C. The Northern Rivers is close behind at 34%, and MNCCC is planning more training, resources and hep C treatment promotion throughout regional prisons.

The sessions were well-attended, with 76 participants all reporting an increase in knowledge and confidence to better support clients into testing and treatment for hep C. The feedback also described a sustainable hep-network, engaged workforce and thought-provoking discussions, with highest praise reserved for our positive speakers who worked hard and inspired all by smashing stereotypes with quiet truth.

Hepatitis NSW gratefully acknowledges the support of the HARP and JH&FMHN staff for promoting and supporting the program and making it such a success.

Keep an eye out for more Get Bloody Serious training dates coming in 2019.

Cycle to End the Cycle in Maroubra

In late November, Hepatitis NSW ran a hep B and hep C focused education activity at the Maroubra Surf Life Saving Club. This was part of a larger activity, called Cycle to End the Cycle, organised by Aboriginal Health Worker Kevin Heath. It was an event aimed at ending the cycle of young Aboriginal people not speaking out about their problems, and was partnered with local sporting clubs.

Over the course of 12 hours – with 15 minute slots – a set of six riders would take turns on a row of exercise bikes, with plenty of onlookers, family and friends urging them on, and with a playlist of tunes blasting out to keep their energy up. More than 300 people were engaged in the activity.

Most people did a couple of cycle sessions, and between rides they visited our health area stalls.

Almost 150 people came and interacted with us, or browsed and took away resources. We displayed and distributed resources, ran a Chocolate Wheel – with questions about hepatitis transmission, prevention, treatment and myths and facts – and then gave people tickets to go in the hourly draw to win $50 shopping vouchers. We had many conversations about hep B and hep C with visitors to the stall, and talked with people from a wide range of ages.

South East Sydney Local Health District HARP Unit staff, Aboriginal Health Promotion workers, and Playsafe Sexual Health Educators were alongside us, covering sexual health, and safe sex practices, along with a stall run by headspace who addressed youth mental health issues.

Young people enjoyed visiting our stall, and had heaps of fun looking at resources, hearing information, trying out and choosing from the free merchandise, and learning, then answering quiz questions. Groups of up to six at a time engaged and interacted with many young people sharing their own knowledge and strategies with their friends.

A big thank you goes to Rusty Nannup from SWOP, who worked with Hepatitis NSW’s Maria McMahon, at the stall on the day and, to SES LHD who provided a grant to deliver the activity.