Tx! Mag #24

edition

24

Sept 2016

change of plans

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PART ONE This is one of the common areas.

We come here to relax and hang out when we’re not locked in.

On a good day, about eight hours.

More than you’d get at a higher classo.

How often is that, Natalie?

Girls, this is Lola. She’s new, and this is her first time on the inside, so be nice.

lola, this is tanya...

...rhonda... ...Shantelle... ...jo-anne... ...and ...ebony... laquesha.

Hi.

hey. hey lola. wassup?

welcome to melarancio. I’m Laquesha and that’s all you need to know.

welcome.

Knowing Laquesha is fine, but you probably need to know a few other things too.

Like where the toilets and mess hall are.

Come on.

it’s nice to meet you.

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what’s happening, girl?

Mess hall?

What’s a mess hall?

I hope so.

I’m only going to be here eight months. it may not sound like much, but I can’t believe I’m going to be away from my babies for almost a year.

it’s just the name of the room where we eat.

don’t stress about it, you’ll pick up the lingo soon enough.

I have two beautiful kids.

how many kids do you have?

That’s sad.

I’m really going to miss my kids, but I’m trying to stay focussed on seeing them again. I have to feel that connection to them.

there’s Liam, he’s five. and there’s elle. she is three. I miss them so much.

That’s good.

You keep hold of that.

You need a reason to keep you going while you’re in here. Something to look forward to when you get out.

well, don’t get too connected to here then.

Otherwise you’ll end up like me. I’ve got nothing outside of here, so I can’t even imagine myself on the outside.

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one week later.

what’re you guys up to?

well if it isn’t fresh meat lola. we’re just doing a little body art, prison-style.

yeah, I guess so...

hey, I heard you were a bit of an artist on the outside. is that true?

do you reckon you could fix this up for me?

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but I’ve got to admit, I haven’t ever actually done any tattooing before.

I think I can fix that up.

That’s okay, it’s easy! You’re just writing on skin!

okay, I’ll give it a go.

wow, that looks really good!

5

you’ve done a really good job! that’s awesome! great!

I’m glad it turned out okay.

I should totally give you one now!

I... I’m not so sure about that...

6

come on... it’s tradition. you’re inside now, you gotta have one like the rest of us.

it doesn’t have to be YOUR name.

I dunno.

I don’t want my own name tattooed on myself.

yeah, come on. it’s a melarancio tradition.

do you have a kid? it can be their name if you want. ...really?

...okay. I’ll start with my son. his name is liam.

sweet.

CONTINUED PAGE 14

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WHAT HAPPENED TO

?

We’ve made some changes to this magazine, but don’t worry. Everything you love is still here.

Transmission Magazine is now Tx Magazine. The focus has changed a bit. This is because the world of hep C is really different than when Transmission Magazine started. Hep C is now an easily cured infection. It’s time for this magazine to move away from harm reduction and transmission prevention. It will focus more on promoting hep C treatment in future.

We want Tx Magazine to help get people living with hep C into treatment and clearing their hep C. Hepatitis NSW will also do more work on hep B in the next few years. You’ll see stories about hep B as well as hep C in Tx Magazine.

Tx Magazine will still come out three times a year. We’re aiming for two editions a year on hep C treatment and one edition on hep B testing and monitoring.

Tx - abbreviation

onounced treet-ment) Medicine: Treatment (pr or injury. 2. A to a patient for an illness 1. Medical care given . ng ati tre in d technique use substance, therapy or .]

[From French traitement nced tranz-mish-un) Transmission (pronou Telecommunications: t. 2. Something that is ng, e.g. data or broadcas 1. The act of transmitti ection. inf message, picture or an transmitted, such as a onem] [From Latin transmissi

We’ll still be making comics with stories from people affected by viral hepatitis. We’ll still be holding workshops with our communities to write the stories and come up with the characters. And the layout and design of the magazine will stay the same.

So stay tuned and keep reading Tx Magazine! We’ll bring you more great stories and lots of information.

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THE NEW HEP C TREATMENTS

ANY ADULT WHO HAS HEP C GENOTYPES 1, 2 OR 3 AND A MEDICARE CARD

WHO ARE THEY FOR?

TRIED OLD TREATMENT AND IT DIDN’T WORK? INJECT DRUGS? HAVE LIVER DAMAGE OR CIRRHOSIS? IN PRISON?

TALK TO YOUR DOCTOR, NURSE OR CLINIC ABOUT STARTING TREATMENT

WANT TO KNOW MORE? Call our Hepatitis Infoline 1800 803 990 or look up our website www.hep.org.au 9

Hep C treatment in prison ilable. They have ➲➲ New treatments for hep C are now ava and they work for fewer side effects than older treatments more people. nts in NSW prisons. ➲➲ You can access the new hep C treatme ple in correctional They're available to everyone, even peo centres. tence needs to be ➲➲ To treat your hep C in prison, your sen le course. The new long enough for you to complete the who If your sentence treatments take between 8 and 24 weeks. treat your hep C is shorter than this, you can get ready to when you are released. t to see the Justice ➲➲ The first step is to make an appointmen e that you would Health nurse at your Centre. Tell the nurs like to be treated for hep C. . They will do some ➲➲ Starting treatment may take some time you. These may tests to find out which treatment is best for oscan is a quick, include blood tests and a Fibroscan. A Fibr s how stiff and pain-free test like an ultrasound. It measure damaged your liver is. ing list for treatment. ➲➲ After your tests, you will go on a wait each Centre.

The length of the waiting list is different in nt by calling the ➲➲ You can find out more about treatme calls list from Hepatitis Infoline. Dial 3 on the common munity. prison, or call 1800 803 990 from the com

10 10

Justice Health Nurse photo by Ute Wegmann

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8 things to know about hepatitis B New treatments for hepatitis C are getting a lot of attention. It’s easy to forget about hepatitis B, but it’s just as important. Here’s 8 things you should know about hepatitis B.

1. Hepatitis B and hepatitis C are different viruses They share a first name, but hepatitis B and hepatitis C are different from each other. They both affect the liver. “Hepatitis” just means inflammation (swelling) of the liver. Because they are different viruses, hepatitis B and hepatitis C have different tests and treatments.

2. hepatitis B is transmitted in three main ways These include:

➲➲ ➲➲ ➲➲

Mother-to-baby transmission during childbirth.

Through blood-to-blood contact.

Through sex without the use of barriers like condoms.

A person needs to have hepatitis B to pass it on to someone else. Blood and sexual fluids can only pass on hepatitis B if one person has the virus in their body. Hepatitis B can’t be passed on by hugging or kissing, by sharing plates or cutlery, or by sneezing or coughing.

Hepatitis B is most often passed on during childbirth. Lots of people living with hepatitis B in Australia got it from their mothers who were born overseas.

3. around 213,300 people in Australia have hepatitis B That’s a little less than 1% of Australia’s population. It’s a lot more common than people think.

Out of the people in Australia who have hepatitis B: ➲➲ 38% were born in the Asia-Pacific region and 4% were born in Sub-Saharan Africa. ➲➲ 9% are Aboriginal and/or Torres Strait Islander. ➲➲ 6% are people who inject drugs. ➲➲ 4% are gay or bisexual men or other men who have sex with men.

4. A huge 44% of people living with hepatitis B in Australia don’t know they have it Testing for hepatitis B isn’t as common as it should be. Lots of people haven't been diagnosed.

Some groups of people are at more risk of coming into contact with hepatitis B. Think about getting tested for hepatitis B if you belong to any of these groups: ➲➲ People from migrant backgrounds (especially people from the Asia-Pacific or SubSaharan Africa). ➲➲ Aboriginal and/or Torres Strait Islander people. ➲➲ Children born to mothers with chronic hepatitis B.

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Other groups who are at higher risk of infection include: ➲➲ Gay and bisexual men and other men who have sex with men. ➲➲ Sex workers. ➲➲ People who inject drugs. ➲➲ People who have close or intimate contact with people living with hepatitis B (like partners, housemates, or family members) ➲➲ People who have been in custodial settings like prison. ➲➲ People who are getting dialysis. (Dialysis is a medical process for people with kidney failure. It removes waste from their blood.) ➲➲ People living with HIV, hepatitis C, or chronic liver disease.

These groups of people can get vaccinated against hepatitis B for FREE!

5. About 90 – 95% of unvaccinated adults who come into contact with hepatitis B will clear it naturally Exposure to hepatitis B causes an infection called acute hepatitis B infection. The word “acute” means “short term”: this period lasts about six months. You can transmit the virus in this period. You may have symptoms like nausea and pain in your abdomen.

BUT! Most adults will fight the virus off naturally in that six months. And if you've been vaccinated, you are immune and will clear the infection straight away. If you clear hepatitis B, you will be immune to hepatitis B from then on.

6. If you don’t clear hepatitis B, it can become chronic “Chronic” means that the infection is ongoing and long-term. Chronic hepatitis B can cause cirrhosis, liver cancer or liver failure if it’s not treated. THIS IS MOSTLY PREVENTABLE! It is possible to look after your hepatitis B and stay healthy. Many deaths from hepatitis B are due to people not knowing that they have it and not being monitored by a GP. Hepatitis B can’t be cured, but there is treatment available to help you manage the virus and look after your liver.

7. Around 90% of unvaccinated children who come into contact with hepatitis B will develop chronic hepatitis B Children who are exposed to hepatitis B are much, much less likely to clear it naturally.

Most people who have hepatitis B got it while their mother was giving birth to them.

Luckily, pregnant women in Australia are usually screened for hepatitis B. Babies born to mothers with hepatitis B can get a shot at birth that protects them from hepatitis B. Unvaccinated children who are exposed to hepatitis B are likely to develop a chronic infection. This means that they will need to monitor their hepatitis B for the rest of their lives.

Making sure your children get vaccinated on time is the best way to protect them from hepatitis B.

8. There is a safe and effective vaccine for hepatitis B This is great news! Getting a vaccine is the easiest and most effective way to avoid hepatitis B and stay healthy. And if enough people get vaccinated, we can stop hepatitis B transmission in Australia completely. Talk to your doctor or nurse about vaccination for yourself and your children.

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PART TWO what?!

a few days later.

oh, it’s nothing.

what’re you looking at?

Come on, show me.

{sigh} you got a tattoo done. it’s infected. you need to go to the clinic and have it looked at.

no, I don’t want to get into trouble.

and I don’t want to cause trouble for anyone else either.

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you’ve already got trouble, girl. it’s infected. And the infection may be the least of it.

this is exactly how it happened to me. how what happened?

oh wow, I’m sorry...

how I contracted hepatitis C.

you’ve been reckless and now you need to take responsibility.

no need to be sorry. what you need to do is be sensible. you need to get the infection seen to straight away and book in for a hep c test in a couple of months*.

but I don’t want anyone to get into trouble.

*Hepatitis C has a window period of eight to twelve weeks. This is the amount of time from when a person is exposed to the virus to when antibodies or virus can be detected in their blood. If you think you have been exposed to hepatitis C, you will need to wait until after the window period before you can be accurately tested.

Nobody is going to get into trouble.

if you go to the medical clinic, then it is all private. There are rules about privacy when it comes to medical treatment.

I’m positive.

The clinic is there to help you. Not to dob you in.

are you sure? now, come on. let’s get you down to the clinic before that gets worse.

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over the next few months...

lola settles into life in prison.

she makes friends...

and passes the time.

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until...

{sigh}

what’s up jelly cup?

I just got my results back from my PCR test*.

*There are two blood tests to test for hepatitis C. An antibody test tells you if you have ever been exposed to hepatitis C. If this comes back positive, you will need a PCR test to find out if you have chronic hepatitis C.

I guess from the look on your face that you’re positive for Hep C?

yeah, that’s right.

it’s okay you know.

Take it from someone who lived with hep C for years.

There’s a lot you can do about hep C these days.

Most hepatitis C transmissions in Australia are spread through shared injecting equipment. Hepatitis C can be passed on through tattooing if the tattoo gear isn’t sterile.

This is much more common in prison because it’s so hard to sterilise your equipment.

I can’t believe it was all from a tattoo.

I thought people only got hep C from sharing needles and drugs

I just wanted to fit in. I wanted to be part of the group. and now I’ve got hep c from getting liam’s name tattooed on my arm.

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Liam! Elle!

What am I going to do about my kids now I have Hep C?

what do you mean, “What You’re going am I going to do what you to do?” were always going to do.

You’re going to do your time here, and then you’re going to go home and be a great mum to those kids.

but this changes everything. I’m going to have to be careful around my kids.

There are some small precautions that you’ll have to take, but nothing too major.

I promise.

And hep C is now easily curable. I had hep C for years before I did treatment and I know what got rid of it.

I’m talking about.

we’re going to make a phone call.

come on, come with me to the common room. there are some things we can do. some resources you can use. should I get myself tested?

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Okay.

You’re going to be calling the Hepatitis infoline.

it’s run by Hepatitis NSW. They can answer pretty much any question you might have.

Hello, this is the Hepatitis infoline, you’re speaking with Anna, how may I help you?

it’s number three on the common calls system. That means it’s free and can be called by anyone in a NSW prison.

Yeah… hi Anna.

My name is Lola. I was… uhhh, I was just diagnosed with Hep C and I was wondering about my options for treatment.

Certainly Lola, you’ve called the right place. There are a lot more options for people living with hep C than there used to be.

The new treatments are much shorter and have far fewer side effects than the old interferon-based treatments you might have heard about.

There’s no injections anymore, either – it’s just daily tablets.

I can talk you through some of the things you can do to access treatment.

That’s good to know. Although I should tell you I’m calling from Melarancio correctional center. But I get out in just a few months.

Well that’s fine. if you’re getting out soon, you may want to wait until you’re released before you start treatment.

But there are a few things we can do to prepare for your treatment before you get out.

like what?

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Well the first thing we can do is get you a blood test to determine the genotype of hepatitis C that you have.

They are called genotypes. There are six main genotypes of hepatitis C, with some being more common than others in Australia.

Knowing which genotype of hepatitis C you have will help decide which medication you should take.

What does that mean?

Well the hepatitis C virus comes in several strains with different genetic make-ups.

Oh? That’s interesting.

And I can just find that out with a blood test?

Yes, that’s right. it’s called a PCR genotype test. You may have already had a PCR test when you were diagnosed.

It’s the same test, but this time the clinic will use it to find out which genotype of hep C you have. You can organise to have the blood test right there at the clinic in Melarancio. you can be ready to start treatment as soon as you’re released.

That’s great.

I want to be ready for my kids, and ready to get started when I get out.

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Another test that you’re going to have to get is a fibroscan, or transient elastography.

A fibroscan is like an ultrasound that checks your liver for fibrosis. This just means finding out if your liver has hardened or scarred and how much it’s been damaged

that sounds like it could be painful.

no, not at all. it’s a quick, easy pain-free procedure. that’s good!

But I guess it’s not something the clinic nurse in here can do. some correctional centres do have a portable fibroscan and more are being rolled out.

You’ll need to find a doctor to prescribe the medication when you’re released. This no longer has to be a liver specialist and can now be a GP in the community.

They’ll be able to refer you to get a fibroscan if you can’t get one before you’re released. Would you like me to find you a doctor in your home town who can treat your hep C? that’s really good, but first I want to ask about how this could affect my kids.

I’ve been worried about that.

well, generally it won’t affect them much, but there are a few simple precautions you can take to ensure that you won’t pass the virus on to them.

For Example, you can make sure that you never share a toothbrush.

looks like she’s dealing with it really well.

hope I deal with it that well if my test comes back positive.

I wouldn’t do that anyway. exactly. most of the things aren’t a big deal.

You will.

I’ll help you too.

what other things should I do?

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and so, over the next few weeks, Lola got herself ready for her hepatitis treatment.

she used the resources available to her...

...and the support of her friends.

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to be ready in time for her release.

ready to face the future with her kids.

THE END

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picture b

picture a spot 8 differences between pictures a&b

1) Rhonda has a different face 2) The building's colours are different 3) The bench is black 4) The woman behind Laquesha is missing 5) The fence in the background is missing 6) Tanya's headband has been removed 7) Jo-Anne's beanie is a different colour 8) Natalie's "pointing" hand is missing

the difference

word search

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EDUCATION AND TRAINING SESSIONS We design workshops and education sessions for people who work with communities affected by hep C and hep B. We can come to you or you can come to us. We can tailor our workshops to suit your needs, and we include a C'een & Heard speaker who has lived experience of hep C. For more information about our education and training services, please email info@hep.org.au If you or your community want to be part ofTx Magazine, please email info@hep.org.au. We can put together a training package for your organisation and help produce a story that could become a future edition of the magazine.

FIND A CHEMIST DIRECTORY Need to find a chemist to fill your script for the new hep C treatments?

You can search the directory on our website to find a chemist near you who can fill your script. All the chemists in our directory have confirmed that they will fill scripts for the new treatments.

Go to www.hep.org.au/services-directory/ and put in your postcode.

SPEAKERS WANTED Do you have lived experience of hepatitis B or hepatitis C? Your story is powerful. You could become a positive speaker with our C'een & Heard service. Your personal account of living with viral hepatitis could educate people attending our workshops. Our paid speakers play a valuable role in challenging myths and stereotypes about viral hepatitis. Contact info@hep.org.au or call the Hepatitis Infoline on 1800 803 990 for more.

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Have you seen our new, mobile-friendly Hepatitis NSW website?

Check it out at www.hep.org.au It's full of information about hep C and hep B. Find out how to look after yourself and protect yourself and others.

Scan me with your smartphone to visit our site.

want more of tx magazine?

You can have Tx Magazine delivered to you. Sign up as a Hepatitis NSW member for free at www.hep.org.au or call 1800 803 990.

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n o i t s e u q r e w s n a &

with the

Q A

HEPATITIS INFO, SUPPORT, REFERRAL

Do the new hepatitis C treatments cure people living with chronic hep C? The short answer is Yes! The new treatments have an average cure rate of about 95%.

Successful hep C treatment completely cures a person of hep C. It rids the body of the virus and once it’s gone it won’t come back unless the person is reinfected.

We are very excited about the new direct acting antiviral treatment drugs, often called ‘DAAs’, that have been listed on the Pharmaceutical Benefits Scheme (PBS). This means that the Government has subsidised them to be more affordable – you can access them for less than $40 per script for people with a Medicare card, and around $6 per script for people with concession cards.

The new treatments are much more likely to cure a person of their hep C than the old treatments as well as having much fewer side effects. Talk to your GP, nurse or clinic about getting started.

“Cure” or “SVR” (for Sustained Virological Response) means that someone has cleared the hep C virus from their body. You'll have a blood test to check your viral load 12 weeks after you finish treatment. If this shows undetectable (which means no virus) you are considered to be cured.

If hep C has caused a lot of liver damage, clearing the virus might not mean you are completely healthy again. You may still need specialist care and monitoring. Talk to your doctor about what “cure” will mean for you.

send your questions to us ON

sms: 0404 440 103 ph: 1800 803 990 e: info@hep.org.au

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dial 3 on the Common Calls list (free!)

IF YOU HAVE A QUESTION CALL

HEPATITIS INFO, SUPPORT, REFERRAL

HEPATITIS INFOLINE

1800 803 990 INFO, SUPPORT, REFERRALS

Call 131450 to organise an interpreter service You also can now chat to us live at hep.org.au

the survey HOW TO GO IN THE DRAW TO WIN $50 go to

OR

E FILL OUTNTDHYOU SURVEYDAWIN A COUL UCHER $50 VO

IT'S EASY!

www.surveymonkey.com/r/TXED24

AND FILL OUT THE SURVEY ONLINE BY 1 JANUARY 2017

1 FILL OUT THE SURVEY ON THE BACK OF THIS PAGE 2 CUT THIS PAGE OUT OF THE MAGAZINE

3 FOLD IN HALF ALONG THE BLACK DOTTED LINE BELOW, SO THAT THE ADDRESS IS ON THE OUTSIDE

4 STICK THE 2 SIDES CLOSED WITH STICKY TAPE OR STAPLES (ALONG THE YELLOW EDGES ABOVE AND BELOW)

5 PUT IT IN THE POST TO US BY 1 JANUARY 2017 (NO NEED TO BUY A STAMP, IT'S FREE TO SEND)

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the survey 2.After reading thisTx Magazine, I know more about keeping healthy with hep C

3. I think this Tx Magazine is useful to me 4. Since reading this Tx Magazine, (tick all that apply) I have called the Hepatitis Infoline I have looked up the Hepatitis NSW website at www.hep.org.au

Strongly agree

Agree

Neither

Disagree

Strongly disagree

Strongly agree

Agree

Neither

Disagree

Strongly disagree

Strongly agree

Agree

Neither

Disagree

Strongly disagree

5. How do you think we could make this magazine better?

I have talked to someone else about my hep C I have made an appointment with my doctor or liver clinic I have made changes to my lifestyle I know how hep C is passed on I have made no changes

QUESTIONS ABOUT YOU 6. How old are you?

7. Are you:

male

11. Please describe yourself: (tick as many as you like) Person with hep C Person cured of hep C

female

trans/inter

8. What is your current postcode (or prison name)?

Partner/relative/friend of person with hep C Person with hep B Current prisoner Ex-prisoner

9. Do you speak a language other than English with your family?

GP or Health Care Worker Community or youth worker

No, only English

Person who currently injects drugs

Yes, the other language I speak is:

Person who used to inject drugs Worker in NSP sector

10. Are you Aboriginal and/or Torres Strait Islander?

Yes

No

Worker in AOD or OST sectors Other (please say)

12. If you would like to go in the $50 voucher draw, please give us your name and phone number, email address or prison MIN (optional). This prize offer is for NSW residents only - one draw per person.

Phone number: Name: or email address or MIN : 13.Would you like to be sent up-to-date hepatitis news and information? Write your email address here:

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Email address:

Hepatitis NSW respects and upholds your right to privacy protection. In accordance with National Privacy Principles, we have a detailed policy and set of procedures regulating how we collect, use, disclose and hold your personal information. For a copy of the policy, please contact us on 02 9332 1853 or visit our website: www.hep.org.au

IT'S EASY!

QUESTIONS ABOUT THIS MAGAZINE 1. After reading this Tx Magazine, I feel I know more about hep C

UT FILL THISYOOU AND IN A COULD W ER $50 VOUCH

SPECIAL THANKS . . . to the education unit at dillwynia correctional centre

The Education Unit delivers training programs that provide inmates of Dillwynia Correctional Centre (Womens) with the skills needed to work safely, competently and productively within associated work programs. The Unit also assists inmates with developing career pathways leading to realistic opportunities for employment or further training after their release.

EDITOR/DESIGNER Heather McCormack EDITORIAL COMMITTEE Tim Baxter Jenny Douglas Margaret El-Chami Paul Harvey Alastair Lawrie Sonam Paljor Lucy Pepolim Kate Pinnock Shana Quayle Rhea Shortus Megan Stapleton Robert Wisniewski COMIC WRITER Lawrence Gergich COMIC ARTIST Daryl Toh www.gestaltcomics.com

Hepatitis NSW would like to thank the women from Dillwynia for their creativity in developing this edition of Tx Magazine.

ASIDE FROM HEPATITIS NSW EDITORIAL CONTENT, VIEWS EXPRESSED IN THIS MAGAZINE OR FLYERS ENCLOSED WITH IT ARE NOT NECESSARILY THOSE OF HEPATITIS NSW OR THE ORGANISATIONS WITH WHOM WE COLLABORATE. NEITHER ARE SUCH VIEWS NECESSARILY THOSE OF OUR FUNDING BODIES. TX MAGAZINE DOES NOT PROMOTE OR CONDONE THE USE OF ILLICIT DRUGS. RATHER, IT SEEKS TO PROVIDE ACCURATE INFORMATION THAT WILL HELP PEOPLE WHO ALREADY USE DRUGS TO REDUCE RISKS AND MAKE SAFER CHOICES. NOTHING IN THIS MAGAZINE SHOULD BE TAKEN AS RECOMMENDING DRUG USE.

If you are a youth or health worker and would like to know more about how your clients can contribute to the development of Tx Magazine call the Hepatitis Infoline on1800 803 990 or email info@hep.org.au

Hepatitis Infoline 1800 803 990 (freecall) Hepatitis NSW p: 02 9332 1853 f: 02 9332 1730 PO Box 432 Darlinghurst, NSW 1300 info@hep.org.au Level 4, 414 Elizabeth Street Surry Hills Sydney 2010 www.hep.org.au Hepatitis NSW is proud to acknowledge Aboriginal people as the traditional owners and custodians of our lands and waters.

ABN 30 408 095 245 A non-profit health promotion charity funded by the NSW Ministry of Health. Accredited by the Quality Improvement Council of Australia (QIC). Donations of $2 and over are tax deductible.

IONS?

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MAGAZINES ALL OUR PAST AT: ARE ONLINE u/news-stand/ www.hep.org.a

PH: 1800 803 990 info@hep.org.au www.facebook.com/hepNSW @HepatitisNSW