#70 HepSA Community News

Community News

#70 • June 2016

More New Treatments The Future of Advocacy • Prison Treatment

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FREE! Please take one

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Hepatitis SA provides free information and education on viral hepatitis, and support to people living with viral hepatitis.

About the Front Cover: O’liver at Tarpari: see p6.

Correspondence: Please send all correspondence to The Editor at PO Box 782, Kent Town, SA 5071, or email editor@ hepatitissa.asn.au.

Editor: James Morrison

Street Address: 3 Hackney Road, Hackney Postal Address:

PO Box 782 Kent Town SA 5071

Phone:

Fax:

(08) 8362 8443 1800 437 222 (08) 8362 8559

Online:

www.hepsa.asn.au admin@hepatitissa.asn.au

Contents

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The Future

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New Treatments

HEPATITIS SA BOARD

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Treatments Forum

Chair Arieta Papadelos

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Tarpari Wellbeing Day

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Marra Dreaming

Vice Chair Bill Gaston Secretary Lindsay Krassnitzer Treasurer Sam Raven Ordinary Members Catherine Ferguson Ratan Gazmere Kristen Hicks Nicci Parkin Kerry Paterson (EO) Sharon Jennings Jeff Stewart

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10 Reconciliation Week 11 Prison Treatment Forum 14 Research Update 15 What’s On 16 In Our Library Disclaimer: Views expressed in this newsletter are not necessarily those of Hepatitis SA. Information contained in this newsletter is not intended to take the place of medical advice given by your doctor or specialist.

We welcome contributions from Hepatitis SA members and the general public.

SA Health has contributed funds towards this program.

9/06/2016 2:39:12 PM

A Hep-Free World?

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n Saturday, 28 May, the 194 Member States of the World Hepatitis Alliance made a historic commitment to eliminate viral hepatitis by 2030. The Global Health Sector Strategy for viral hepatitis—whose goal is the elimination of hepatitis B and C by 2030, and includes prevention and treatment targets to reduce annual deaths by 65% and increase treatment by 80%— was unanimously adopted, signalling the greatest global commitment on viral hepatitis ever.

At the World Health Assembly, 35 countries made an intervention, committing their support for the strategy.

The majority of countries, including Greece, Japan and Brazil, demonstrated strong political commitment to eliminate viral hepatitis.

Other countries, in particular UK and Thailand, noted that the targets were ambitious and it would be difficult for many countries to meet them by 2030 without support from the World Health Organization (WHO) and other global organisations.

Many other countries raised the issue of treatment costs and the considerable barriers to access, and again called for the WHO to assist and

collectively work to lower the cost of interventions.

Germany and Australia reiterated the importance of universal health coverage (systems like Australia’s Medicare) to strengthen health systems. Indonesia and Germany underscored the importance of using the strategy to reach vulnerable populations and to tackle stigma, as without tackling stigma elimination isn’t possible.

Within the session, a number of countries addressed the issues of high-quality generic medicines (which are invariably cheaper than ‘brand’ medication), pricing and the importance of national plans, in particular around harm reduction and blood and injection safety.

Overall, governments indicated their support to eliminate viral hepatitis, but reiterated their need for support from WHO and other global bodies.

This is a momentous occasion, and one which we should celebrate. However, the work doesn’t stop here. As an international community, we must continue to work together to ensure that countries honour their commitments and implement activities to reach the targets.

As a first step, members can use the strategy to lobby their national governments, especially about the specific interventions the strategy calls for. The upcoming World Hepatitis Day on July 28, 2016, offers a great opportunity to start these conversations. This year the theme is elimination of hepatitis. NOhep, a global movement aimed at galvanizing support for the elimination of viral hepatitis by 2030, will be launched.

You can find out more at the World Hepatitis Day website (visit worldhepatitisday.org).

Also coming up is the second World Hepatitis Summit (in March 2017), under the theme of ‘Implementing the Global Health Sector Strategy on viral hepatitis: Towards elimination of hepatitis as a public health threat’.

The amazing thing is that over just the last few years, advances in treatment have meant that, with enough government will and support, elimination of hepatitis is a real possibility.

If governments do not take the lead in meeting the targets, we—the community—will.

Download the strategy at http://bit.ly/wha-hepstrat.

June 2016 • HEPATITIS SA COMMUNITY NEWS 70

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New Treatments Welcome But More Needed

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PREVIR A VIR/ ASVIR & BUVIR

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1

Another new medication, This good news is tempered he Pharmaceutical grazoprevir and elbasvir by the fact that some people Benefits Scheme (PBS) in combination, is going living with less common listing of Viekira Pak before the Pharmaceutical hepatitis C genotypes are and Viekira Pak-RBV at the Benefits Advisory Committee still desperately waiting for start of May this year was (PBAC) in July. PBAC is new treatments to become a% very welcome addition OPLE the body which makes available without the terrible to the highly effective D recommendations about side-effects of the older new generation treatment which treatments should options for people living with medicine. be available on the PBS. If hepatitis C. There are six main genotypes PBS-listed, this medication is of the hepatitis C virus, It followed the PBS listing intended to treat people with and in Australia the most of the new sofosbuvir, genotypes 1, 4 and 6.

R ledipasvir and daclatasvir prevalent genotypes are KS* In the meantime, people with 1 and 3, making up 90% medications at the beginning the less common genotypes of cases. The currently of March. Australian clinical (4, 5 or 6) can talk to their approved treatments in data recently released hepatitis specialist or nurse Australia provide a number demonstrates an overall cure about clinical trials or early of interferon-free options rate of greater than 95% . access programs being for genotypes 1, 2 and 3.

Viekira Pak is the brand CARD conducted by pharmaceutical Under current guidelines, name for a new multi-drug companies. people with genotypes 4, 5 treatment regimen for and 6 still have to experience hepatitis C genotype 1, which the debilitating side-effects REA TMENT . combines the medications associated with pegylated paritaprevir-ritonavir, Thinking of interferon. ombitasvir and dasabuvir, getting onto the Trials of treatment regimens used with, or without, new hepatitis C that are effective across all ribavirin. hepatitis C genotypes (panSeveral thousand people have treatment? genotypic medicines) are commenced treatment using continuing, but it is currently Call us on 1800 437 222 the new medications in the unclear how long Australians last few months. Preliminary Ask for the will need to wait for these data suggests that the to become available on the Hepatitis Helpline number of people receiving PBS. Once approved, the treatment in March 2016 introduction and PBS listing We will link you to viral was as large, or perhaps even of pan-genotypic medicines hepatitis nurses who larger, than the number of will be the next major step people receiving hepatitis C will work with you to get in treating and eliminating treatment during the entirety ready for treatment. hepatitis C in Australia. of 2014.

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HEPATITIS SA COMMUNITY NEWS 70 • June 2016

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8

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TALK TALK TOTO YOUR YOUR DOCTOR, DOCTOR, NURSE NURSE OR OR CLINIC CLINIC ABOUT ABOUT GETTING GETTING READY READY FOR FOR TREATMENT TREATMENT HARVONI HARVONI (SINGLE (SINGLE PILL)PILL)

SOVALDI SOVALDI (PILLS) (PILLS)

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R/ & IBAVYR & IBAVYR (PILLS) (PILLS) / & R

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SOFOSBUVIR SOFOSBUVIR && RIBAVIRIN RIBAVIRIN

SOFOSBUVIR SOFOSBUVIR && LEDIPASVIR LEDIPASVIR

SOVALDI SOVALDI (PILLS) (PILLS) & DAKLINZA & DAKLINZA (PILLS) (PILLS)

VIEKIRA VIEKIRA PAK PAK (MULTIPLE (MULTIPLE PILLS) PILLS)

==

SOFOSBUVIR SOFOSBUVIR && DACLATASVIR DACLATASVIR

==

PARITAPREVIR/ PARITAPREVIR/ RITONAVIR/ RITONAVIR/ OMBITASVIR OMBITASVIR && DASABUVIR DASABUVIR SOMETIMES SOMETIMES WITH WITH RIBAVIRIN RIBAVIRIN

FORFOR GENOTYPES GENOTYPES

FORFOR GENOTYPE GENOTYPE

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TALK ABO

THE THENEW NEWHEP HEPCCTREATMENTS TREATMENTS

OF PEOPLE OF PEOPLE CURED CURED

OF PEOPLE OF PEOPLE CURED CURED

8,8,12 12OROR24 24 WEEKS* WEEKS*

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WEEKS* WEEKS*

OF PEOPLE OF PEOPLE CURED CURED

FORFOR GENOTYPE GENOTYPE

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%% 95 95 OF PEOPLE OF PEOPLE CURED CURED

12 12OROR24 24 12 12OROR24 24 WEEKS* WEEKS*

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WHO WHOARE ARETHEY THEYFOR? FOR?

ADULTS ADULTS WHO WHO HAVE HAVE HEP HEP C GENOTYPES C GENOTYPES 1, 2 1,OR 2 OR 3 AND 3 AND A MEDICARE A MEDICARE CARD CARD MOST MOST PEOPLE PEOPLE HAVE HAVE NO OR NO VERY OR VERY MILDMILD SIDE-EFFECTS SIDE-EFFECTS

MOST MOST PEOPLE, PEOPLE, TREATMENT TREATMENT IS USUALLY IS USUALLY TAKEN TAKEN FORFOR 12 WEEKS 12 WEEKS * FOR * FOR

PEOPLE PEOPLE WITH WITH GENOTYPES GENOTYPES 4 - 64ARE - 6 ARE TREATED TREATED WITH WITH SOFOSBUVIR SOFOSBUVIR TAKEN TAKEN WITH WITH PEGYLATED PEGYLATED INTERFERON INTERFERON ANDAND RIBAVIRIN RIBAVIRIN TREATMENT. TREATMENT. THEY THEY HAVE HAVE MORE MORE THAN THAN A 90% A 90% CHANCE CHANCE OF CURE. OF CURE.

FOR FOR MORE MORE INFORMATION: INFORMATION: Call Call thethe Hepatitis Hepatitis SASA Helpline Helpline onon 1800 1800 437 437 222 222 or or visit visit www.hepsa.asn.au www.hepsa.asn.au

June 2016 • permission.

HEPATITIS SA COMMUNITY NEWS 70 Based Based on aon design a design

by Hepatitis

by Hepatitis NSW, NSW, and and used used with with permission.

SA Health SA Health has contributed has contributed fundsfunds towards towards this Program. this Program.

Published Published MayMay 2016.

2016.

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9/06/2016 2:39:25 PM

By the Books New treatments forum at City Library

W

ith the new direct-acting antiviral (DAA) hepatitis C treatments added to the Pharmaceutical Benefits Scheme, 9 out of 10 people with hepatitis C can now be cured with very few side effects. However, many in the community still do not know about the treatments or how to access them.

To help get the message out, Hepatitis SA facilitated a community information forum at the City Library on 8 April, just over a month after the treatments became available.

Centre and Lyell McEwen Hospital), with Jeff associated with the QEH and working from Wongga Turtpaendi Aboriginal Health Service in Port Adelaide.

The Viral Hepatitis Clinical Practice nurses provide a link between a person wanting hepatitis C treatment, their GP and one of the specialists at the hospital.

Also presenting at the Community Forum was

The Viral Hepatitis Clinical Practice Nurses can assist the GP to perform all of the correct tests to ensure

Presenters included Jeffrey Stewart, one of SA Health’s Viral Hepatitis Clinical Practice Nurses. Jeff and his colleagues work out of the major hospitals in Adelaide (the Royal Adelaide Hospital, the Queen Elizabeth Hospital (QEH), Flinders Medical

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treatment can be started with as few visits to the specialist as possible.

This is hugely helpful in both reducing the stress for those wanting hep C treatment and freeing up the hospital’s services.

GPs can also prescribe in consultation with a specialist.

Community Forum

HEP C: TREAT ME

Find out about the new hepatitis C treatments! Meet South Australia’s free Hepatitis Treatment Nurses, and hear from someone who was cured through these new medications.

• Higher cure rates (more than 90%) • Shorter treatment times (12 weeks for most) • Minimal side-effects (interferon-free for most)

Friday, 8th April, 2016 • 1—3pm Adelaide City Library, cnr Rundle Mall and Francis Street Free entry • Afternoon tea provided To register, please email education@hepsa.asn.au or call Tess or Claire on 8362 8443

Peer Education and Support Project worker Karan promotes the event

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ect

PBS to cover prisoners’ hepatitis C treatments

Jeffrey Stewart, one of SA Health’s Viral Hepatitis Clinical Practice Nurses, explains the new treatments

Hepatitis SA Outreach Hepatitis C Peer Education and Support Project worker Karan Olson. Karan spoke to the group about her experiences on the new medication, which has cured her of hepatitis C after more than three decades of living with the virus.

Karan had previously attempted Interferon- and Ribavirin-based treatments with no success. Her liver was becoming increasingly damaged by her hepatitis C, so in 2014, Karan sought out a trial of the new treatment drugs through the Royal Adelaide Hospital. She was lucky enough to receive one of the DAA medications and cleared hepatitis C in approximately 12 weeks.

The information forum was closed with a presentation from Deborah Warneke-Arnold. Deborah is the co-ordinator of the Hepatitis SA Information and Support project, within which sits the Hepatitis SA Helpline.

Deborah’s program also runs regular support groups, ‘Calming the C’. The group meets fortnightly at Hepatitis SA’s Hackney office and monthly at Wongga Turtpaendi Aboriginal Health Service (see p15 for dates). Where possible, the Viral Hepatitis Clinical Practice Nurses also attend the groups to provide additional information and support.

The forum was really well attended and participants

shared an afternoon tea once the presentations were complete. Many took advantage of the opportunity to speak with the presenters and have their treatment questions answered. A quiz was held, with a main prize of a $50 Coles Myer voucher, and the winner announced at the event. This created a bit of extra excitement for those present.

Feedback on the event was really positive and we hope to hold more community information forums on topics of interest to the community. If you have any suggestions for forum topics, please give us a call at Hepatitis SA on 1800 437 222.

Claire Hose Educator

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9/06/2016 2:40:17 PM

Tarpari Wellbeing celebrations at Port Pirie

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arpari Wellbeing Day is Port Pirie’s biennial celebration of health, community and Aboriginal culture and reconciliation. ‘Tarpari’ means ‘healing’ in the Nukunu language and provides an overarching premise for the day, with this year’s theme being ‘Together, let’s close the gap’. This community event had much to offer the whole community of Port Pirie and the Mid North area.

A full day of activities and information was packed into a little over four hours, including traditional Aboriginal Dancers, Aboriginal entertainers, art displays, health information and attractions, such as a reptile zoo and Kondoli the story-telling whale—and Hepatitis SA! Tarpari attracts a wide range of services, both local to the area, and like us, from Adelaide; services like Families SA, the Department of Human Services, Aboriginal Legal Services, Cancer Council

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SA, Aboriginal Health Council of SA, Aboriginal Drug and Alcohol Services, Life Without Barriers, SA Dental Services and UniSA just to name a few.

Two educators from Hepatitis SA travelled to Port Pirie with the purpose of promoting the new hepatitis C treatments.

O’liver also came along for what was sure to be a funfilled day.

To engage community members at the event, we facilitated a quiz with the chance to win a $50 voucher. This has been a very successful engagement tool in the past, and it was no different at Tarpari. Over 100 people visited our stall

to learn about the new hepatitis C treatments through the quiz. The community members were very interested in learning about the new treatments, as many people only knew of the old ones. People told us they would pass the information on to family and friends who were living with hepatitis C, and some even said they would visit their GP to discuss commencing the treatment.

While the educators were busy informing people about the new hepatitis C treatments, our mascot O’liver got up to lots of mischief. He visited Wildlife on Wheels and held a snake, played on the bouncy castle, ventured into the Rural Health ‘Mega Body’, to make sure they had the liver in the correct spot, played with a whale, hung out with camels and of course met lots of community members.

As a second engagement tool, we also provided craft supplies for people to make a beaded bracelet which they could take away with them. With these two activities, we believe the day was a success.

Tarpari is a very well organised event, and we encourage other services to consider attending. In 2018, we definitely hope to be a part of the event again.

Jenny Grant Education Co-ordinator

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9/06/2016 2:41:01 PM

Marra Dreaming Aboriginal women’s health and art workshop

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‘The Womens Meeting Place’ by Jannette Barna, courtesy of Marra Dreaming

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ndigenous Australians are four times as likely to be hospitalised for chronic health conditions, compared with other Australians. Viral hepatitis is one of the serious and chronic conditions affecting the health of Aboriginal and Torres Strait Islander people in Australia.

It’s also known that women play an integral role in the health and wellbeing of their families and communities.

Supporting and exploring

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indigenous culture is another key aspect of Aboriginal and Torres Strait Islander wellbeing.

Hepatitis SA wanted to provide a culturally appropriate program for Aboriginal women to strengthen their health literacy, build knowledge and skills, all in a respectful and affirming manner. To achieve this, staff at Marra Dreaming kindly invited Hepatitis SA staff to join in with a group

over four weeks in March and April to talk about hepatitis B and C and how it affects Aboriginal and Torres Strait Island communities.

Marra Dreaming is an indigenous arts centre, based in Salisbury. It is a safe, welcoming space where community can share their creativity and have a yarn about worries, stresses, safe relationships, health and wellbeing. Every Monday, a

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women’s social connect group meets to practice traditional arts such as dot painting and basket weaving.

Between five and eight women attended the session each week. Beautiful dot paintings were created by the women, including a piece titled ‘The Turtle Dance’, and a series of paintings depicting pelicans in different scenes and poses. Women talked with Hepatitis SA staff about the information they’d been given and how it related to their lives and the communities in which they live. The new treatments created a lot of excitement as the women knew people in their communities, families and friendship networks who would benefit from them.

Call Us! Free, confidential information and support on viral hepatitis:

1800 437 222

The program was a wonderful learning experience for both staff and the participants, and it was an excellent opportunity to share our stories and understand more about each other.

Marra Dreaming produce and sell a wide range of contemporary Aboriginal craft and artwork. They are open from Monday to Thursday, 9am to 3:30pm.

Drop in and have a look at their gallery and showroom— you will be amazed at the level of local talent!

Claire Hose Educator

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Together

Celebrating Reconciliation Week

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ogether, the National Reconciliation Week event at the Adelaide Town Hall, was a warm, relaxed celebration of collaboration among services working with Aboriginal communities.

The event was brought together by Hepatitis SA, Aboriginal Community Connect, Streetlink Youth Health, New ROADS, Aboriginal Sobriety Group, SHine SA, Karrparrinthi Aboriginal Health and Wellbeing Centre, SAMESH and Nunkuwarrin Yunti to mark the importance of working together to promote awareness of our oldest living continuous culture and embed community knowledge to promote respect and understanding.

Together was a community ‘awareness raising’ event in the City Council’s beautiful

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Meeting Hall.

We enjoyed live music from Nathan May, a passionate emerging artist from the Arabana (SA), Yawuru (WA) and Malak Malak (NT) clans. Margaret Richards demonstrated traditional basket weaving, with her wonderful skills amidst information stalls, activities and lucky draws.

The Adelaide City Council provided the Quick Response grant which made Together possible.

According to the City Council, Together fitted in well with the City Community’s priorities by reaching out to meet the needs of isolated and marginalised groups with the sharing of information to help individuals and families get the help required for recovery and healing.

We would like to thank Epicure for catering the event, Charlesworth Nuts for their kind donation of a Feastful of Flavours basket and Oz Harvest for their support with the Aboriginal Community Connects’ PopUp Café.

Most of all, we thank all who attended the event to help achieve meaningful Reconciliation as we continue to strive to reduce the health inequities between Aboriginal and Non-Aboriginal South Australians that exist in our community today.

Together we are strong, Together we are healthy.

Lisa Carter Coordinator, Outreach Hepatitis C Peer Education & Support Project

Nathan May (left) performs and Margaret Richards (ricght) weaves at Together, with (centre) a community-created piece of art made live by those attending the event.

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Prison Treatment

Obstacles and opportunities

Professor Andrew Lloyd

“W

e’re hoping for the development of a new hepatitis treatment that’s not genotype-specific,” said Professor Andrew Lloyd of the University of NSW, keynote speaker at May’s HepLink Forum. “We’re calling it ‘perfectovir’.”

The forum was organised

by Hepatitis SA, Relationships Australia SA and the MOSAIC counselling service to discuss the topic ‘Eliminating Hepatitis C in South Australian Prisons: Realistic target or wishful thinking?’.

Professor Lloyd was there

to present the findings of his extensive research on HCV treatment in the NSW corrections system, which included a national needs assessment about hepatitis C treatment in Australian prisons.

priority population for assessment and treatment.”

As part of Professor Lloyd’s research, conducted with Michael Mokhlis Mina (of the Inflammation and Infection Research Centre at the University “Hepatitis C infections of NSW), Lilie Herawati are prevalent in custodial (of pharmaceutical settings worldwide, but company MSD Australia) the provision of antiviral therapies is uncommon,” and Tony Butler (also of the University of NSW), he explained. “Roughly interviews were conducted 30,000 prisoners are held in Australian prisons at any with 55 stakeholders from the correctional one time, with over 30% sector in each state and testing positive for HCV territory in Australia. antibodies. And prisoners have been identified in the National Hepatitis C Strategy as an important

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First of all, service directors were questioned to gather quantitative data regarding rates of testing and treatment.

Then other stakeholders were interviewed to get qualitative information

“The barriers that were identified to assessment and treatment at the prisoner level included the fear of possible side effects and the stigma of being identified to the prison authorities as HCV-infected and therefore

approaches to how prison hepatitis services could be improved.”

likely to be an injecting drug user. Prisoners who came forward were also sometimes considered unsuitable for treatment because of prevalent mental health problems and ongoing injecting drug use.

HCV-uninfected prisoners who injected drugs, each of whom had a baseline HCV test at enrolment.

The subjects were followed up at 6-monthly intervals with structured interviews and HCV testing at each follow‐up. A couple of major problems were frequently encountered which indicated the

Professor Lloyd is also involved with the Hepatitis C Incidence & Transmission Study, which enrolled high‐risk,

Professor Andrew Lloyd

regarding the barriers to treatment and testing, as well as the opportunities.

“We found that, of more than 50,000 individuals in custody in Australian prisons over the course of 2013, about 8,000 were HCV antibodypositive, and yet only 313 prisoners received antiviral treatment,” Professor Lloyd explained.

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“The provision of specialist hepatitis nurses and consultants was the most frequently recommended

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difficulties for prisoners seeking treatment.

access to it,” Professor Lloyd explained.

The first significant problem was the extraordinary number of times that a prisoner can be moved around the system, from prison to prison, in the course of a year. Having access to treatment, medical staff

The second was the lack of clean needle programs in the prison system, meaning that a prisoner could easily be reinfected during their treatment, or soon after finishing it.

“Corrections staff unions simply won’t wear a CNP

the RAH’s Viral Hepatitis Centre), Emma Williams (from Mosaic Counselling Services), and Fiona Woollard (who spoke movingly about beating hepatitis C while in prison, using one of the new treatments), all of whom were involved in a robust and lengthy panel

From L to R: Denise Agius, Fiona Woollard, Andrew Lloyd, Anton Coleman, Emma Williams, Dr Michael Findlay and Janice Scott

and information in one location does not mean that this availability will follow the prisoner around the system. “In the time it takes to complete a course of treatment a prisoner might be moved two or even three times, and lose

system in NSW prisons, and there’s no obvious way around this.”

Other speakers were Janice Scott (Clinical Nurse with the South Australian Prison Health Service), Anton Coleman (Clinical Practice Consultant at

discussion at the end of the forum, along with Dr Michael Findlay (Medical Head of Unit at the South Australian Prison Health Service) and Denise Agius (Aboriginal Liaison Officer with the Department for Correctional Services).

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Stigma & Ignorance

Medicine, not drugs, caused HCV explosion

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he stigma which attaches to people living with hepatitis C is a well-known problem, fuelled by ignorance about how the virus is spread and assumptions about how it might have been contracted.

A recent Canadian study, however, demonstrates that these assumptions are quite wrong-headed. (Note that, although these results reflect the North American population, they have some validity for Australia as well.)

Around 6 million North Americans (3 million in the US, and 3 million in Canada and Mexico) are living with chronic hepatitis C. It is estimated that 75% of them are ‘baby boomers’, born between 1945 and 1965. Because Hepatitis C is frequently asymptomatic for many years or even decades, many of these baby boomers remain undiagnosed.

The US Centers for Disease Control and Prevention (CDC) estimates that baby boomers are five times more likely to have hepatitis C than those born before or after them. Previous studies have identified infected blood products and the use of injecting drugs as the main factors driving the spread of HCV in baby boomers.

Although there can be several ways to acquire this blood-

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borne virus, the association with injecting drug use as the cause of infection has exacerbated hepatitis C’s negative stigma.

The Vancouver-based retrospective phylogenetic study examined the timing of the initial spread of HCV genotype 1a in North America (the most common genotype on the continent) by analysing over 45,000 sequences. The results, published in the Lancet: Infectious Diseases journal in March 2016, found that the majority of the spread of genotype 1a in North America occurred before 1965, that hepatitis C saw its greatest infection rates between 1940 and 1965, and that the North American HCV epidemic stabilised around 1960.

Looking at the results in greater detail, the analysis suggests that the period of 1948 to 1963 saw the biggest explosion of HCV, which is a great deal earlier than was previously thought.

As the study authors say, “Based on our results, the oldest members of the demographic cohort with the highest burden of hepatitis C virus (the baby boomers) were roughly five years of age around the peak of the spreads of genotype 1a in North America in 1950.

Thus, it is unlikely that past

sporadic risky behavior (experimentation with injecting drug use, unsafe tattooing, high risk sex, travel to endemic areas) was the dominant route of transmission in this group.”

In turn, this leads to unsafe medical procedures as the root cause of hepatitis C’s spread in the baby boomer population. The early expansion of the virus coincided with the increase in the number of medical procedures conducted during World War II and its immediate aftermath.

The study authors point out that immediately after the war, injection and blood transfusion technologies were still in their infancy, and before 1950 injections were given in glass and metal syringes, which were sterilised manually and frequently re-used.

Disposable syringes were only phased in during the decade before 1960.

While the risk of contracting hepatitis C through sharing drug-injecting equipment remains significant, this study show that its prevalence in the population today is not due to the use of illict drugs, but that the spread of hepatitis C between 1948 and 1963 is a casualty of the development of modern medicine.

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Affected by hepatiti

Affected by hepatitis C? Photo © S. Allen

Calming the C 2016 Dates

Calming the C: Hackney

• Information and support in a confidential, 12.30–2.30pm Hepatitis SA, 3 Hackney Rd, Hackney Tuesday, 13 September Tuesday, 19friendly January environment Tuesday, 10 May Tuesday, 27 September Tuesday, 24 May • Speak to others who have had treatment Tuesday, 2• February Partners, family and friends welcome Tuesday, 16 February Tuesday, 1 March Tuesday, 15 March Tuesday, 29 March

Tuesday, 7 June Tuesday, 21 June

Tuesday, 11 October Tuesday, 25 October

Tuesday, 5 July Tuesday, 19 July

Tuesday, 8 November Tuesday, 22 November

2016 Dates

Calming the C: Hackney Now12.30–2.30 meeting at HACKNEY, ELIZABETH pm Hepatitis SA, 3 Hackney Rd, Hackney Tuesday, 6 December Tuesday, 12 April Tuesday, 2 August Tuesday, Tuesday, May Tuesday, 20 13 December September ADELAIDE Tuesday, 10 16 August Tuesday, Tuesday, 19 26 January April and PORT Tuesday, 24 May Tuesday, 27 September Tuesday, 30 August information, phone 8362 8443 Tuesday, 2For February Tuesday, 16 February June Tuesday, 11 October SeeTuesday, over721for Tuesday, Junedates Tuesday, 25 October

CALMING the C in the NORTH 2016 Dates

Tuesday, 1 March Tuesday, 15 Tuesday, 5 July 16 Playford Tuesday, November 1–3 pmMarch RoomC20, GP plus Elizabeth, Blvd, 8Elizabeth Tuesday, 29 March Tuesday, 19 July Tuesday, 22 November Thursday, 21 January Thursday, 12 May Thursday, 1 September Thursday, 18April February Tuesday, 12 Tuesday, 26 April Thursday, 17 March

Hepatitis C peer educators are also available to provide information and support to clients at the following services:

DASSA Central Services Hepatitis C Treatment Clinic 91 Magill Rd, Stepney Tuesdays 9–12am DASSA Central Pharmacy Thursdays Calming the C: Hackney 9–12am • Information and support in a confid

Calming the 2016 Dates

12.30–2.30pm Hepatitis SA, 3 Hackney Rd, Hackney environment Tuesday, 13 Tuesday, 19 Januaryfriendly Tuesday, 10 May DASSA Southern Service 27 Tuesday, 24 May • Speak to others who haveTuesday, had trea Tuesday, 2 February 82 Beach Rd,• Partners, family and friends welcom Tuesday, 16 February Tuesday, 11 Christies Beach Tuesday, 7 June Tuesday, 21 June Tuesday, 25 Monday monthly Tuesday, 1 March Tuesday, 8 N Tuesday, 15pm March Tuesday, 5 July 10am–1 Tuesday, 19 July Tuesday, 22 Tuesday, 29 March Upcoming dates:

2016 Dates

Calming HackneyELIZ Now meetingtheat C: HACKNEY,

12.30–2.30 pm Hepatitis 3 Hackney Rd, Hackney Ring12 Lisa 84432SA, Tuesday, 6 D Tuesday, Aprilon 8362 Tuesday, August Tuesday, Tuesday, 19 January Tuesday, 10 May and PORT ADELAIDE for details Tuesday, 16 August Tuesday, 13 20 Tuesday, 26 April

Tuesday, Tuesday, 27 Tuesday, 24 30 May August Tuesday, 2 February Tuesday, 16 February Service Tuesday, 7 June Tuesday, 11 DASSA Northern Tuesday, 21 June Tuesday, 25 22 Langford Dr, Elizabeth Tuesday, 1 March Thursday fortnightly Tuesday, 15 Tuesday, 5 July 16 Playford Tuesday, 1–3 pmMarch RoomC20, GP plus Elizabeth, Blvd, 8EliN 10 am –12 pm Tuesday, 29 March Tuesday, 19 July Tuesday, Thursday, 21 January Thursday, 12 May Thursday,22 1

For information, phone 8362 See over for dates

CALMING the C in the NO 2016 Dates Upcoming dates:

Thursday, June Thursday, September Tuesday, 29August Tuesday, 629 December Tuesday, 16 August Tuesday, 20 December Thursday, 27 October Thursday, 7 July Tuesday, 30 August 12.30–2.30 pm Hepatitis SA, 3 Hackney Rd, Hackney24 November Thursday, 14 April Thursday, 4 August Thursday, Tuesday, 19 January Tuesday, 10 May Tuesday, 13 September Tuesday, 24 May Tuesday, 27 September Tuesday, 2 February Tuesday, 16 February Tuesday, 7 June Tuesday, 11 October 1–3pm RoomC20, GP plus Elizabeth, 16 Playford Blvd, Elizabeth Church St &Tuesday, Dale St, 25 Port Adelaide 12–2pm Wonggangga Turtpandi, Tuesday, cnr 21 June October Thursday, 21 January Thursday, 12 May Thursday, 1 September Tuesday, 1 March Tuesday, 23 August Tuesday, 3 May Tuesday, 12 January Tuesday, 59July Tuesday, November Tuesday,18 15 February March Thursday, Thursday, June Thursday,820 29 September Tuesday, September Tuesday, Tuesday, February Tuesday,9 29 March Tuesday, 31 19 May July Tuesday, 22 November Thursday, 17 March Thursday, 7 July Thursday,18 27October October Tuesday, Tuesday, 28 June Tuesday, 8 March Tuesday, 2 August Tuesday, 6 December Tuesday, 12 April Tuesday, Thursday, 14 April Thursday, 4 August Thursday,15 24November November Tuesday, Tuesday, April Tuesday,5 26 April Tuesday, 26 16 July August Tuesday, Tuesday,20 13December December Tuesday, 30 August

Thursday, 18April February Thursday, June Thursday, Tuesday, 629 D Tuesday, 12 Tuesday, 29August Ring 26 Lisa on 8362Tuesday, 8443 16 August Tuesday, April Tuesday, 20 Thursday, 27 Thursday, 17 March Thursday, 7 July for details Tuesday, 30 August 12.30–2.30 pm Hepatitis SA, 3 Hackney Rd, Hackney Thursday, 14 April Thursday, 4 August Thursday, 24 Tuesday, 19 January Tuesday, 10 May Tuesday, 13 Septe Tuesday, 24 May Tuesday, 27 Septe Hutt Street Centre Tuesday, 2 February 258 Hutt St, Adelaide Tuesday, 16 February Tuesday, 7 June Tuesday, 11 Octo 1–3pm RoomC20, GP plus Elizabeth, 16 Playford Blvd, Eli Wednesday weekly Turtpandi, cnr Church St & Dale25 St,Octo Por 12–2pm Wonggangga Tuesday, 21 June Tuesday, Thursday, 21 January Thursday, 12 May Thursday, 1 Tuesday, 1 March 10am–12.30 pm Tuesday, 2 Tuesday, 3 May Tuesday, 12 January 5 July9 June Tuesday, 8 Novem Tuesday, 15 March Thursday, 18 February Tuesday, Thursday, Thursday, 29 Tuesday, 2 Tuesday, 31 May Tuesday, Tuesday, February Tuesday, Tuesday, 299March 19 July 22 Nove Thursday, 17 March Thursday, 7 July Thursday, 27 Tuesday, 1 WestCare Centre Tuesday, 28 June Tuesday, 8 March Tuesday, 2 August Tuesday, 6 Decem Tuesday, 12 April Tuesday,24 1 Thursday, 14 April Thursday, 4 August Thursday, 17 Millers (off Wright Tuesday, 26 July Tuesday, 20 Dece Tuesday, AprilCourtTuesday, Tuesday, 265April 16 August Tuesday, 1 St), Adelaide Tuesday, 30 August

CALMING the C at the PORT 12–2 Wonggangga Turtpandi, cnr Church St & Dale St, Port Adelaide CALMING Tuesday, the 3CMayin the NORTH Tuesday, 23 August Tuesday, 12 January

CALMING the C at the POR CALMING theTuesday, C 3inMaythe NORT Tuesday, 2 Tuesday, 12 January

Calming the C: Hackney

CALMING the CALMING theCCinatthe the NORTH PORT

pm

Calming the C: Hackney

CALMING the CALMING theCCinatthe the NO POR

Wednesday weekly 10.30 am–12.30pm Wonggangga Turtpandi, cnr Church St & Dale St, Por 12–2pm

1–3pm RoomC20, GP plus Elizabeth, 16 Playford Blvd, Elizabet pm RoomC20, GP plus Elizabeth, 16 Playford Blvd, Elizabeth has 1–3 been discontinued due to low attendance.

Tuesday, 20 September Tuesday, 2 Thursday, 21 January Thursday,31 12May May Thursday, 1 September Thursday, 12 May 1 Septe Tuesday, Tuesday, 31 May Thursday, Tuesday, 9 February Tuesday,219 January February Thursday, Tuesday, 18 October Tuesday, 1 Thursday, 18 February Tuesday, Thursday,28 9 June Thursday, 29 September Thursday, Thursday, 9 June June Tuesday, 28 June Thursday, 29 Sept Tuesday, 8 March Tuesday,188 February March Tuesday, 15 November Tuesday, 1 Thursday, 17 March Thursday,26 7 July Thursday, 27 October Thursday, Thursday, 7 July26 July Thursday, 27 Oct Tuesday, July Tuesday, Tuesday, 5 April Tuesday,175 March April Tuesday, 13 DecemberJune 2016 • HEPATITIS SA COMMUNITY NEWS 70 15 Tuesday, 1 Thursday, 14 April Thursday, 4 August Thursday, 24 November Thursday, 14 April Thursday, 4 August Thursday, 24 Nov HepSA Community News 70.indd 15

CALMING the C at the PORT

9/06/2016 2:42:18 PM

CALMING the C at the PORT

Resources for, or about, young people ‘Knowledge is power. Information is liberating. Education is the premise of progress, in every society, in every family.’

—Kofi Annan In that spirit, here are some useful resources to support families, or anyone working with young people, to feel more empowered and capable when dealing with hepatitis and related conditions.

I’m bloody awesome: a board game about sexual health and blood borne viruses Northern Territory AIDS and Hepatitis Council, Darwin, This board game contains relevant and up-to-date information and aims to empower young people to take ownership of their sexual health behaviours and choices.

In our library 2.4 NTA 30 What about me? For children when a parent has cancer.

Cancer Council Queensland A comic style book which provides basic factual information and explores possible feelings, fears and concerns relevant to children.

In our library: 7.6 CCQ 27

Baby baby Office of Aboriginal Health, Dept of Health Western Australia & Inception Strategies, Perth.

A comic book aimed at encouraging Aboriginal women to attend regular check-ups during their pregnancies.

In our library 7.4 INC 62 My Mom has Hepatitis C H. Weinberg and S. Shump, Hatherleigh Press, New York, 2000.

A picture book for young children which tells the story of how Jake and Celia learn to deal with their mother’s viral infection.

In our library: 7.6 WEI 4

How to tell children they have hepatitis C Hepatitis C Support Project, San Francisco, 2013.

Early disclosure is critical to how the child and family cope and live with hepatitis C. This factsheet gives simple and practical advice and information to help adults inform children in this situation.

In our library: 7.6 HCS 34 Staying Healthy: Preventing infectious diseases in early childhood education and care services.

National Health and Medical Research Council, Canberra, 2013.

A best practice tool that provides simple and effective ways for educators and other staff to help limit the spread of illness and infectious diseases in education and care settings.

In our library: 7.6 NHM 13

If you would like to know more about our library, please contact us at hepatitissa.asn.au/library, on 8362 8443 or email librarian@hepsa.asn.au.

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HEPATITIS SA COMMUNITY NEWS 70 • June 2016

HepSA Community News 70.indd 16

9/06/2016 2:42:33 PM

Useful Services & Contacts Hepatitis SA Free education sessions, printed information, telephone information and support, referrals, clean needle program and library.

(08) 8362 8443 admin@hepatitissa.asn.au www.hepsa.asn.au Hepatitis SA Helpline 1800 437 222 (cost of a local call) Adelaide Dental Hospital A specially funded clinic provides priority dental care for people with hepatitis C with a Health Care Card.

Call Hepatitis SA on 1800 437 222 for a referral. beyondblue Mental health information line

Lifeline National, 24-hour telephone counselling service.

Positive Life SA Services and support for HIVpositive people.

13 11 14 (cost of a local call) www.lifeline.org.au

(08) 8293 3700 www.positivelifesa.org.au

Mental Health Crisis Service 24 hour information and crisis line available to all rural, remote and metropolitan callers.

13 14 65 MOSAIC Counselling service For anyone whose life is affected by hepatitis.

(08) 8223 4566 Nunkuwarrin Yunti An Aboriginal-controlled, citybased health service with clean needle program and liver clinic.

SA Sex Industry Network Promotes the health, rights and wellbeing of sex workers.

(08) 8351 7626 SAMESH South Australia Mobilisation + Empowerment for Sexual Health www.samesh.org.au Youth Health Service Free, confidential health service for youth aged 12 to 25.

Youth Helpline: 1300 13 17 19 Parent Helpline: 1300 364 100

1300 224 636 www.beyondlbue.org.au

(08) 8406 1600

Clean Needle Programs in SA For locations call the Alcohol and Drug Information Service, or visit the Hepatitis SA Hackney office.

P.E.A.C.E. HIV and hepatitis education and support for people from nonEnglish speaking backgrounds.

1300 131 340

(08) 8245 8100

Community Access & Services SA Alcohol and drug education; clean needle program for the Vietnamese and other communities.

Viral Hepatitis Community Nurses Care and assistance, education, streamline referrals, patient support, monitoring and follow-ups. Clients can self-refer. Contact nurses directly for an appointment.

(08) 8447 8821

Central

headspace Mental health issues are common.

Find information, support and help at your local headspace centre

North

1800 650 890 www.headspace.org.au

Vincentian Centre Men’s night shelter run by St Vincent de Paul Society.

Assistance hotline: 1300 729 202

Margery - 0423 782 415 margery.milner@health.sa.gov.au Jeff - 0401 717 953 Lucy - 0401 717 971 South

Rosalie - 0466 777 876 rosalie.altus@fmc.sa.gov.au Emma - 0466 777 873

Are you interested in volunteering with Hepatitis SA? Give us a call on 8362 8443 or drop us a line at admin@hepatitissa.asn.au.

We rely on volunteers for many of our vital services.

HepSA Community News 70.indd 1

9/06/2016 2:42:59 PM

HEP C & HEP B WORKFORCE TRAINING! Do you know where to refer clients living with viral hepatitis? Do you know if there is a cure? Do you worry about blood exposure and needle-stick injury?

Sessions cover a range of topics, including: • Basics about hepatitis A, B and C • Transmission risks/myths • Best practice around blood and blood exposure • Discrimination • Lived experience from the perspective of a Positive Speaker • Any other topics relevant to your workplace!

Cost: Free Time:

1-2 hours

Where: In-service: we will come to you!

Contact the Education Team on 8362 8443 or email education@hepsa.asn.au

HepSA Community News 70.indd 2

9/06/2016 2:43:18 PM