Hepatitis C treatment needs among opioid substitution treatment clients in inner-city Sydney

  • Dr Carolyn Day, Central Clinical School and Discipline of Addiction Medicine, University of Sydney, NSW, Australia
  • Mr Scott Rutter, HARP (HIV and Related Programs) Health Promotion Team, Sydney South West Area Health Service, NSW, Australia
  • Ms Janice Pritchard-Jones, AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia
  • Ms Sinaed Sheils, AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia
  • Ms Frances Tenison, AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia
  • Prof Paul Haber, 1) Drug Health Services, Sydney South West Area Health Service; 2) Discipline of Addiction Medicine, University of Sydney, Australia

    • Background: Opioid treatment program (OTP) clients have very high levels of hepatitis C (HCV) infection. Despite increases in the safety and efficacy of HCV treatment, assessment and uptake of HCV treatment has remained low.
    Objectives: To examine HCV needs among clients attending private OTPs in inner-city Sydney and develop an appropriate HCV education tool for such settings.
    Methods: A needs assessment survey of a sample of OTP clients attending two private clinics was conducted. Clients were recruited and interviewed by HCV nurses and received a $15 voucher upon completion. Open-ended interviews were also conducted with OTP staff. Data were analysed using SPSS and descriptive statistics are presented.
    Results: Eighty OTP clients were surveyed, 65% were male. Clients were aged 18-30 years (29%), 31-40 years (42%) and ≥41 years (29%). Prior HCV testing was reported by 98% of clients, 67% reported being HCV positive. Eighty-five percent had heard of HCV antiviral treatment and 48% reported previously discussing HCV treatment in a clinical context. Only a third of clients reported medical check-ups for their HCV. Half the clients reported they would use an on-site HCV clinic, with only 7% expressing concerns; 88% stated a preference for HCV information to be delivered through the OTP, followed by 36% for “other doctor”. Interviews with staff revealed variation and gaps in HCV knowledge and very limited time for HCV education. Findings resulted in the development of HCV education resources for the OTP setting and establishment (or augmentation) of nurse-run HCV clinics across four private and two public OTPs in inner-Sydney South-West. Evaluation of resources and clinics will also be presented.
    Conclusions: These data demonstrate a need and willingness for the development of HCV resources and establishment of clinics at private OTPs.