#77 Hep SA Community News

#77 • March 2018 #

Community News

Time to Act on Treatment FREE!

Please take one

,ĞƉĂƟƟƐ ^ ƉƌŽǀŝĚĞƐ ĨƌĞĞ ŝŶĨŽƌŵĂƟŽŶ ĂŶĚ ĞĚƵĐĂƟŽŶ ŽŶ ǀŝƌĂů ŚĞƉĂƟƟƐ͕ ĂŶĚ ƐƵƉƉŽƌƚ ƚŽ ƉĞŽƉůĞ ůŝǀŝŶŐ ǁŝƚŚ ǀŝƌĂů ŚĞƉĂƟƟƐ͘

Cover: See page 2 for details 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

HEPATITIS SA BOARD Chair Arieta Papadelos Vice Chair Bill Gaston Secretary Lindsay Krassnitzer Treasurer Sam Raven Ordinary Members Catherine Ferguson Ratan Gazmere Kirsten Hicks Sharon Jennings Maggie McCabe Kerry Paterson (EO) Deborah Perks

Contents 1 Mapping Hep C 2 Time for Treatment 4 Treatment Memory Tips 6 Youth Art Project 8 Going Digital 10 Indigenous Prisoners 12 #StopStigma 13 What’s On? 14 In our Library 16 SMART Recovery & Smoking Research 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.

Mapping Hep C íøõĂõ ùă ĄĂõñĄýõþĄ þõõôõô ýÿņ

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øõ ŁĂ㥠þñĄùÿþñü mapping project of chronic hepatitis C shows that the areas of Australia with the highest infection prevalence also have the lowest treatment rates.

Chronic hepatitis C prevalence is generally higher in rural and regional locations, and lower in metropolitan areas.

The First National Hepatitis C Mapping Project Report contains estimates for 2016 on the prevalence, diagnosis, monitoring and treatment of hepatitis C at the local area, Primary Health Network and State/Territory level. ÜÿĂ Ąøõ ŁĂ㥠Ąùýõ ýñĀă illustrating the geographical diversity of chronic hepatitis

C prevalence and treatment are included in the report.

These highlight local areas where improvements in engagement in care can be made.

These estimates can be used to judge the progress Australia has made towards the National Hepatitis C Strategy 2014-2017 targets, as well as the WHO Global Health Sector Strategy on Viral Hepatitis 2016-2021.

Australia has the potential to treat all people living with hepatitis C and eliminate it from the population, and this information can be used to make sure the areas most needing help are not neglected.

A year on from treatment being placed on the

æøñĂýñóõąĄùóñü ØõþõŁĄă Scheme (PBS), the report found that uptake was less than half the national average of 19% in higher prevalence areas including Western Queensland (6.9%), Northern Territory (9.4%), and Brisbane South (10.7%).

Areas with the highest uptake of treatment included Adelaide (25.9%), North Coast New South Wales (25.3%), and South Eastern Melbourne (25.1%).

Previous reports of estimates of chronic hepatitis C prevalence and treatment uptake have provided only national and state data, which is very broad.

Consider South Australia as an example: it’s a huge geographical area, but almost 80% of the population lives in greater Adelaide. Statewide statistics will not help you work out where to direct ĄĂõñĄýõþĄ õŀÿĂĄă ÿąĄăùôõ ÿö the capital city.

This project provides the ŁĂ㥠㥹ôĉ ÿö üÿóñü ñĂõñă ñüüÿćùþ÷ ĂõăõñĂóøõĂă Ąÿ Łþô gaps in treatment access, and identify priorities to work towards the future elimination of chronic hepatitis C. You can access the full report at bit.ly/2FETRTx. As the report was launched just before we went to press, a more detailed look at the data and its implications will be presented in our next issue.

March 2018 • HEPATITIS SA COMMUNITY NEWS 77

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Time for Treatment

Government-subsidised DAAs may not always be available

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he clock is ticking to eliminate hepatitis C in Australia as a public health issue, and Hepatitis Australia is sounding the alarm.

in Australia if all people living with hepatitis c take ñôĆñþĄñ÷õ ÿö Ąøõ ñŀÿĂôñòüõ ñþô õŀõóĄùĆõ óąĂõ ±ôùĂõóĄ« acting antiviral therapy) that is currently available.

The goal of NOHep by 2030 is realistic and achievable

Talking to the ABC, the CEO of Hepatitis Australia, Helen

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HEPATITIS SA COMMUNITY NEWS 77 • March 2018

Tyrell, explained that fewer than half as many people are currently accessing the direct-acting antivirals as there were immediately after Ąøõĉ ćõĂõ ŁĂ㥠üùăĄõô ÿþ Ąøõ æøñĂýñóõąĄùóñü ØõþõŁĄă éóøõýõ ±æØé² ßþ Ąøõ ŁĂ㥠three months after the listing,

more than 4,000 people a month were taking them, according to Kirby Institute Ł÷ąĂõă ØąĄ ĀĂõüùýùþñĂĉ data suggests that has now dropped to fewer than 1,500 people a month. “The monthly treatment uptake has tanked.”

She said that falling treatment uptake threatened the Federal Government’s commitment to eliminating hepatitis C in Australia by 2030. “We need to take action urgently. We need to get treatment levels up, well above 20,000 people per annum, and we’re falling below that if you’re looking at the trajectories at the moment.”

Revolutionary DAA drugs for treatment of hepatitis C, including ledipasvir and sofosbuvir, were immediately in high demand after listing on the Pharmaceutical ØõþõŁĄă éóøõýõ ñă ĀõÿĀüõ already engaged in hepatitis C care, rushed to take them.

Prior to being listed, these drugs had cost upwards of $20,000. They now cost less than $40.

ANGLICARE SALISBURY: third Thursday of each month, 12.30–4PM 4-6 Church Street Salisbury

While more than 43,000 Australians have accessed them, it has been estimated there are 200,000 Australians with chronic hepatitis C who have not.

attends a Fibroscan. Anyone that commences treatment as a result of their appointment goes into a draw to win a $50 gift card.

Australia led the world in subsidising these drugs for all people over 18 who needed treatment. The Federal Government negotiated to spend more than $1 billion ÿĆõĂ ŁĆõ ĉõñĂă Āñĉùþ÷ ôĂą÷ companies for an unlimited supply of direct-acting antivirals.

êøùă ĀĂÿýÿĄùÿþ ùă ÿŀõĂõô in partnership with the Viral Hepatitis Nurses in the Northern, Southern and Central Adelaide Local Health Networks, who increase access to viral hepatitis care through the provision of treatment, support and integrated care in the community.

“There is an absolute economic imperative to treat as many people as possible over the next three years ćøùüõ Ąøùă ŁĆõ«ĉõñĂ ăąĀĀüĉ deal is in place,” Ms Tyrrell said.

CNP Peers are available full-time at three sites with Fibroscan clinics attached (see details below), as well as attending rostered sessions at other CNP sites around the Adelaide metropolitan area.

ßþ ñþ õŀÿĂĄ Ąÿ ĄĂõñĄ ñă ýñþĉ people as possible, during March, April and May this year the three clean needle program (CNP) sites with full-time Hepatitis SA CNP æõõĂă ñĂõ ÿŀõĂùþ÷ ñ ăøÿćòñ÷ of giveaways. These include up to $10 worth of CNP stock, of the client’s choice, to anyone who books in and

Access to treatment has never been easier. Speak to your friendly CNP Peer at the locations listed below to book an appointment, or call Lisa on 8362 8443 for more information.

PORT ADELAIDE: ŁĂ㥠íõôþõăôñĉ ÿö õñóø month, 9AM–12.30PM 11 Church St Port Adelaide

NOARLUNGA: every second Monday, 9.30AM–12PM Noarlunga Health Precinct Alexander Kelly Dr

Hep C: get cured. I did.

Lisa Carter

March 2018 • HEPATITIS SA COMMUNITY NEWS 77

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Curing Your Hep C Tips for remembering to take every dose

in - green b As - take DA food - get cat ank - yell at b

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aking every dose of your direct-acting antiviral gives you the best chance of a cure. Because many of these drugs are new, it’s not yet clear how missed ôÿăõă ýñĉ ñŀõóĄ Ąøõ ăąóóõăă of your treatment, so it’s better to be safe than sorry and try not to miss any dose.

Remembering every dose óñþ òõ ôùŃóąüĄ õĆõþ ćøõþ motivation is high and the treatment course short, as is the case for most people on the new hepatitis C medicines. The information that came with your drug should advise you on what to

do if you do miss a dose and whether you should take it later or skip it. êÿ ýñûõ ùĄ ýÿĂõ ôùŃóąüĄ some people will already be on other medications and will need to work the new drug into their routine. éÿ øÿć ôÿ ĉÿą ĂõýõýòõĂ Here are a few strategies to try:

Autopilot A lot of what we do in the day is on automatic pilot so an easy way of remembering your dose is to incorporate it into your routine tasks.

You could try putting your

pills next to something you use everyday such as your kettle, toothbrush or cereal box. This can work especially well if you are able to put the pills in the way of or on top of what you need to use such as Ąøõ óÿŀõõ úñĂ

Prompts Another successful method is to use a prompt which is easier than ever with all of the technology available to us. For instance, set a reminder on your phone or download a medicine management app. An app may also be able to manage your scripts and prompt ĉÿą Ąÿ ĂõŁüü Ąøõý ±ăõõ Ąøõ resources section below for some suggested apps). You can also just write a note to put on your fridge or bathroom mirror.

Tracking Keeping track of whether or not you’ve taken your tablet can be another strain on your memory, mainly because we do so many things automatically (try remembering what you had for breakfast!). Transferring your tablets to a dose box could help with this as óÿąüô ýñĂûùþ÷ ùĄ ÿŀ ÿþ ĉÿąĂ calendar or clicking it as done on your phone reminder or

êøùă Āùõóõ ŁĂ㥠ñĀĀõñĂõô ÿþ ÿąĂ òüÿ÷ HepSay, at hepatitissa.asn.au/blog. Come and visit us there!

reminder app. Being able to easily see how many doses you’ve taken can also be a good ĀĂÿýĀĄ Ąÿ ĂõŁüü ĉÿąĂ ăóĂùĀĄ in time so that you have your medication when you need it.

The old trick of turning the pill bottle over after taking a tablet is really not very helpful because there’s no way to know which day you turned it over!

What works for you might be a case of trial and error.

People who need to take several medications a day often combine strategies to try to remember them. Here’s an example: •

Drug 1, to be taken on waking with an empty stomach: keep in a dose box on the bedside table with a glass of water.

•

•

Drug 2, to be taken with food in the morning: keep pill bottle kept on ĄÿĀ ÿö Ąøõ óÿŀõõ úñĂ Drug 3, to be taken once per month: make a phone calendar reminder.

A real challenge can be when you don’t have a set routine or when something out of the ordinary happens, such as eating out or going away.

If this is the case, you are ĀĂÿòñòüĉ òõĄĄõĂ ÿŀ Ăõüĉùþ÷ ÿþ reminders.

Finally, while taking every dose is best, try not to stress if you do miss a dose here or there. ‘Real-world outcomes’ (where cure rates of all patients are compared against the clinical trials) for these drugs are very good and you are still very likely to clear the virus.

Resources The following apps are all Australian and are available for iPhone and Android. All apps collect data about you which is stored by the app owners; you should consider whether this is appropriate for you.

Medadvisor (medadvisor.com. au): Requires you to deposit your script with the chemist. éóĂùĀĄ ĂõŁüüă óñþ òõ ÿĂôõĂõô via the app.

Chemist Warehouse app (search on iTunes): For people ćøÿ Łüü ĄøõùĂ ăóĂùĀĄ ćùĄø this chemist, requires you to deposit your script. Script ĂõŁüüă óñþ òõ ÿĂôõĂõô Ćùñ Ąøõ app. Sends ads to your device.

NPS Medicine Wise Meds List (www.nps.org.au/medicalinfo/consumer-info/keepinga-medicines-list): Has a smartphone app, online form and paper form.

Other resources Our Tips for Managing Medicines card (see issuu. com/hepccsa/docs/adherence_ card) has a weekly tracker so ĉÿą óñþ óøõóû ÿŀ ĉÿąĂ ôÿăõ Send an email to admin@ hepsa.asn.au and we’ll send you one or you can make up a similar tracker yourself.

Rose Magdalene

March 2018 • HEPATITIS SA COMMUNITY NEWS 77

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Youth art project combines screenprinting and education

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ith a generous grant awarded by the City of Port ×ôõüñùôõ ÛþŁõüô Ùÿąþóùü Hepatitis SA Educators had the opportunity to undertake an art project with the lovely young people from Ladder St Vincent Street.

The project took place at Tooth and Nail Art Studio in Adelaide CBD, where local artist, Jake Holmes, taught the nine participants how to screen-print. Participants drew their own designs, and then printed them onto posters and t-shirts.

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HEPATITIS SA COMMUNITY NEWS 77 • March 2018

Throughout the day, participants also learnt about hepatitis C transmission risks and myths, and how to access blood-borne virus testing and treatment.

As well as their brilliant artistic creations, the session’s post-evaluations indicated the participants gained a lot of useful knowledge about hepatitis C. In these post-evaluations, transmission risks were óÿĂĂõóĄüĉ ùôõþĄùŁõô 5,i ÿö the time, indicating that participants could decipher risks from myths (compared to 37% of the time in the pre-evaluation); 100% of participants correctly ùôõþĄùŁõô øÿć Ąøõĉ óÿąüô Łþô ÿąĄ ùö Ąøõĉ ćõĂõ üùĆùþ÷ with hepatitis C (compared to 75% in the pre-evaluation); and 100% of participants óÿĂĂõóĄüĉ ùôõþĄùŁõô Ąøõ percentage of people that can be cured of hepatitis C (compared to only 11% in the pre-evaluation).

We really enjoyed meeting everyone, and look forward to working with them again!

This project was made possible thanks to the support of:

March 2018 • HEPATITIS SA COMMUNITY NEWS 77

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Going Digital and Online Accessing resources wherever you are

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he internet and smart phones have changed the way Australians Łþô øõñüĄø ùþöÿĂýñĄùÿþ ßþ response, community health organisations are going digital.

In an Australian study published in 2014, almost 30 per cent of people sampled in GP clinics said that they had sought health information online and 17 per cent had looked up the health concern they were visiting their GP for that day*.

À íÿþ÷ Ù õĄ ñü Patient use of the internet for health information, Australia Family Physician, Volume 43, No.12, December 2014, æñ÷õă 431«433

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When it comes to stigmatised conditions like hepatitis C and hepatitis B, people are all the more likely to turn to the internet where they can look up information privately and without speaking to anybody.

This means it is vital that the information they get online is accurate and up to date.

The same study above öÿąþô ĄøñĄ ñńąõþĄ ĀñĄùõþĄă ćõĂõ ăù÷þùŁóñþĄüĉ ýÿĂõ likely to have got health information online than the disadvantaged. This makes it all the more important that ñŀõóĄõô°ÿöĄõþ ýñĂ÷ùþñüùăõô °óÿýýąþùĄùõă øñĆõ ñóóõăă to the internet.

Besides making information available on their websites,

HEPATITIS SA COMMUNITY NEWS 77 • March 2018

hepatitis organisations in all Australian states and territories maintain social media accounts where the latest updates on research, policy and treatments are shared. A quick search for “twitter Hepatitis SA”, “facebook hepvic” or “twitter hepatitiswa” will bring up the relevant accounts. ÞõĀñĄùĄùă é× ñüăÿ øñă ñ òüÿ÷° ÞõĀé×ï°ćøõĂõ ùăăąõă ýñĉ be covered in more depth (see hepsa.asn.au/blog).

Australian hepatitis organisations have also all taken to audio-visual channels. YouTube channels share information videos, personal stories and talks.

Radio interviews and audio

Examples of hepatitis-related digital publications available online: inform information info rmat atio ion n ar are e sh shar shared ared ed o over verr ve SoundCloud, Soun So undC dClo loud ud,, wi with th Hepatitis Hep H epat atit itis is Victoria i i h having i a particularly i l l strong presence and Hepatitis SA making a tentative start.

Check out soundcloud. com/hepatitis-victoria and soundcloud.com/hep-sa.

A number of organisations, including Hepatitis SA, also publish their magazines and information material digitally on popular platforms such as issuu, joomag or via their own web servers. (See examples on this page.) In addition to an

up-to-date up p-t -too-da date te digital dig d igit ital al collection col c olle lect ctio ion n that th at mirrors mir m irro rors rs all all its its current cur c urre rent nt print i publications, blii i bl Hepatitis i i SA also maintains online an archive of past magazines and annual reports. (See bit. ly/hepsa_communitynews and bit.ly/hepsa-stackannualreports). Hepatitis NSW too, publishes an impressive collection of print resources on issuu while Hepatitis Victoria and HepatitisWA have their recent years’ magazines on the same digital platform.

Rose Magdalene & Cecilia Lim

• Reaching Out Report bit.ly/hepaus_ro2 • Hepatitis B Testing Infographic bit.ly/hepnsw_btest • Hepatitis B Fast Facts bit.ly/bfastfacts ¹ ÞõĀ Ù íøñĄėă êøñĄ bit.ly/hepcwhatsthat • Travel Safe bit.ly/peace-travelsafe • Eat Well for Your Liver bit.ly/eatwell_liver

March 2018 • HEPATITIS SA COMMUNITY NEWS 77

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The Prisoner Dilemma The Challenges of Aboriginal Prisoner Care in SA

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hile only 2.3% of South Australia’s population is Indigenous, almost a quarter (22%) of people in the State’s prison system are Aboriginal.

The prison population is also rife with blood-borne viruses, including hepatitis Ø ñþô Ù°ĆùĂąăõă ćøùóø ñüăÿ ôùăĀĂÿĀÿĂĄùÿþñĄõüĉ ñŀõóĄ Indigenous people in the general population.

Untreated chronic health conditions (including viral hepatitis, mental illness, diabetes, heart and respiratory diseases, cancer and drug use), compounded by a prisoner’s isolation from

their family and community, and a fracturing in their cultural identity and spiritual wellbeing, can be catastrophic for an Aboriginal person in the prison system.

This means that it is critical that access to good healthcare be a priority. And the only way in which that can succeed is in partnership with South Australia’s Aboriginal community and ×òÿĂù÷ùþñü«ăĀõóùŁó øõñüĄø services.

SA Health, in particular SA Prison Health and Watto Purrunna (the Aboriginal Primary Care Services for Northern Adelaide Local

Health Network), had been seeking an evidence-based ýÿôõü ÿö óñĂõ ăĀõóùŁó Ąÿ the health needs of adult Aboriginal prisoners. It was quickly established that not much existed, so Wardliparingga, the Aboriginal Health Research Unit at the South Australian Health and Medical Research Institute (SAHMRI), was approached to assist in designing an evidence-based model of care.

The engagement of Wardliparingga was a decisive move to acknowledge that Aboriginal research is done best when

The new SAHMRI building, home to íñĂôüùĀñĂùþ÷÷ñ

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HEPATITIS SA COMMUNITY NEWS 77 • March 2018

in the hands of Aboriginal people, and this research is vital: it can save lives.

that would give us the opportunity to inform policy and practice.

“The objective of this research was challenging for us, and we had to discuss many of the complex health needs of our community,” explain Heather Agius and Evelyn Varcoe, representatives of the Adelaide Grannies Group, a peer support network of Aboriginal grandparents who advocate on behalf of issues ñŀõóĄùþ÷ ĄøõùĂ óøùüôĂõþ grandchildren and their community.

“Our Elders hope that this resulting model of care will be taken seriously by governments, and that stakeholders will make it their business to participate and implement the changes.”

ęØĉ õĈĀüÿĂùþ÷ ôùŀõĂõþĄ stakeholders’ points of view, and by sharing what kind of ‘model of care’ we could design to address the broad needs of Aboriginal adult prisoners, we highlighted the need for qualitative research

The new Model of Care for Aboriginal Prisoner Health and Wellbeing for South Australia emphasises that Aboriginal prisoners are members of communities both inside and outside of prison, and that their release into the wider community at the completion of their sentences needs more consideration. It notes the unique needs of remanded and sentenced prisoners, and ôùŀõĂùþ÷ þõõôă òĉ ÷õþôõĂ

The model has eight core elements: • pre-release planning begins at entry to prison • culture, spirt and identity • communication • access and continuity • family • łõĈùòüõ ĀñĄøćñĉă • recovery, rehabilitation, therapy • prisoners need to be linked to communitybased services pre-release SA Health has acknowledged the challenges to the Model of Care’s implementation, but has enthusiastically endorsed it for implementation.

You can download the report or its executive summary from SAHMRI at bit. ly/2FaZr2Q.

March 2018 • HEPATITIS SA COMMUNITY NEWS 77

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Stopping Stigma

WHA’s new international campaign

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tigma stops the majority of people living with viral hepatitis enjoying the quality of life they deserve. From social exclusion and inferior healthcare to denial of employment opportunities and verbal assaults, stigma and discrimination stop people living with viral øõĀñĄùĄùă öĂÿý öąüŁüüùþ÷ ĄøõùĂ potential.

According to a new report published by the World Hepatitis Alliance (WHA), more than 90% of countries surveyed reported stigma and discrimination to some ôõ÷Ăõõ éÿýõ ÿö Ąøõ Łþôùþ÷ă include:

relationships. Yet, despite this, very few respondents felt that their government ćñă õŀõóĄùĆõüĉ ñôôĂõăăùþ÷ ùĄ on a national level, making stigma and discrimination ñ ăù÷þùŁóñþĄ òñĂĂùõĂ Ąÿ Ąøõ elimination of viral hepatitis.

On Zero Discrimination Day (1 March 2018), WHA launched its year-long global awareness-raising campaign called #StigmaStops, in an õŀÿĂĄ Ąÿ øù÷øüù÷øĄ Ąøõ ĄĂąõ impact of stigma, dispel myths and encourage people living with the disease to speak out. Þÿć óñþ ĉÿą ÷õĄ ùþĆÿüĆõô

• Almost 3 in 4 respondents ăąŀõĂ öĂÿý ăõüö« stigmatisation • Over half of respondents have been socially isolated • 1 in 2 people have experienced unjust barriers to healthcare • 42% have lost out on job opportunities or income The report, entitled Holding Governments Accountable: World Hepatitis Alliance Civil Society Survey Global Findings Report, found that stigma not ÿþüĉ ñŀõóĄă ñþ ùþôùĆùôąñüėă ability to access diagnostics and treatment but also impacts their personal life, mental health and ability to work, learn and maintain

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HEPATITIS SA COMMUNITY NEWS 77 • March 2018

The easiest way is to share the #StigmaStops graphics on social media: download them from bit.ly/2FZrmTU. We can only hope to tackle stigma and discrimination if the voices of people living with viral hepatitis are heard: WHA’s ‘Wall of Stories’ welcomes stories from people living with viral hepatitis to help educate, tackle stigma and highlight the true impact of this disease. You can share your experiences of stigma or explore those of others at the Wall of Stories at worldhepatitisalliance.org/ wall-stories.

Affected by hepatitis C? 3KRWR ‹ 6 $OOHQ

DASSA Central Services Hepatitis C Treatment Clinic 91 Magill Rd, Stepney Tuesdays 9–12AM DASSA Central Pharmacy Thursdays 9–12AM

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HACKNEY 3 Hackney Rd 12.30–2.30PM • • • • • • • • • •

Tuesday, 10 April Tuesday, 8 May Tuesday, 5 June Tuesday, 3 July Tuesday, 31 July Tuesday, 28 August Tuesday, 25 September Tuesday, 23 October Tuesday, 20 November Tuesday, 18 December

PORT ADELAIDE Wonggangga Turtpandi, cnr Church St & Dale St

12–2PM • • • •

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

Tuesday, 3 April Tuesday, 1 May Tuesday, 29 May Tuesday, 26 June

Additional dates for Port Adelaide are still to be conďŹ rmed.

DASSA Southern Service 82 Beach Rd, Christies Beach Monday monthly 10AM–1PM Upcoming dates: Ring Lisa on 8362 8443 for details DASSA Northern Service 22 Langford Dr, Elizabeth Thursday fortnightly 10AM–12PM Upcoming dates: Ring Lisa on 8362 8443 for details Hutt Street Centre 258 Hutt St, Adelaide Wednesday weekly 10AM–12.30PM WestCare Centre -3 ĂŁĂšĂźĂźĂľÄ‚Äƒ ÙÿąĂĄ ¹ÿŀ íĂÚáøĄ St), Adelaide Wednesday weekly 10.30AM–12.30PM

Ma M March arc arc rch 2018 201 201 20 18 8 • HEPATITIS HEEEP H PATI PA TITI IT TIIS SA SA COMMUNITY COM OMM MU UN UNI NIITY TY NEWS NEW EWS 77 77

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Good food habits for your liver Low sodium recipes Mayo Clinic, Rochester USA (website accessed Feb. 2018).

You may have noticed a number of our recent blogs and tweets have focused on how to sustain your health by eating (and drinking) wisely (you can check them out at hepatitissa. asn.au/blog and twitter. com/K3myliver).

There’s been good news öÿĂ óÿŀõõ ôĂùþûõĂă and sound advice about how to check and lower your salt and sugar intake. Here are some more resources (taken from our online library catalogue) that will hopefully encourage you to get on track for a more healthy, vibrant life.

A huge range of online recipes (including beverages, sauces and dressings) all made with less than 140mg of sodium per serving (recommended daily intake is 2000mg sodium/1 teaspoon of salt). bit.ly/lowsodium_mayo

No added salt diet for advanced liver disease Gastroenterological Society of Australia, Sydney, 2012.

5 page information sheet about understanding salt content in packaged foods, how to read those tricky labels and how to use healthier alternatives in home cooking. bit.ly/noaddedsalt

Þù÷ø ŁòĂõ øù÷ø ĀĂõòùÿĄùó diet for healthy individuals Monash University, Dept. of Gastroenterology, Melbourne (website accessed Feb. 2018).

Research, recipes and videos about a prebiotic diet designed to establish a healthy balance of gut bacteria, needed for optimal health. òùĄ üĉ³øù÷øŁòĂõĀĂõòùÿĄùó

Ùÿŀõõ óÿþăąýĀĄùÿþ ñþô Ąøõ liver – the potential health òõþõŁĄă British Liver Trust, London, 2016.

A number of studies are reviewed in this report which concludes that regularly drinking moderate amounts ÿö óÿŀõõ óñþ ĀĂõĆõþĄ üùĆõĂ cancer and lower the risk of other liver conditions. òùĄ üĉ³òüĄ óÿŀõõòõþõŁĄă

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HEPATITIS SA COMMUNITY NEWS 77 • March 2018

What to eat if you have hepatitis C

A brief overview of liver toxic herbs

Medical News Today, Bexhillon-Sea, 2018.

Hepatitis C Support Project, San Francisco, 2015

7 page article which gives an overview of: how hepatitis ñŀõóĄă Ąøõ ôùõĄ öÿÿôă Ąÿ õñĄ and foods to avoid.

Focuses on the issues of standardisation, possible contamination, deceptive claims and a list of herbs and herbal supplements that may harm the liver.

bit.ly/hcv_diet Spice it up: recipes using exotic herbs from around the world

bit.ly/toxicherbs_liver

Healthy Eating Local Policies and Programs (HELPP), Adelaide, 2012.

Part of a project from Flinders University: “Resources for ćÿĂûùþ÷ õŀõóĄùĆõüĉ ćùĄø CALD Communities”. This book contains recipes which incorporate a variety of herbs and spices from around the world.

These resources should all be available, free to access, online: if you have any problems retrieving any of them please contact us (admin@hepsa.asn.au) and we’ll assist you.

If you would like to check out the complete collection of resources about nutrition: scroll down to the ‘Quicklinks’ section of our library page (hepatitissa.asn.au/ library) and click on the ‘Lifestyle’ heading.

bit.ly/food_caldcommunities Herbal glossary Hepatitis Support Project, San Francisco, 2017 Describes various herbs: the safety concerns, interactions with other medications and potential harms to the liver.

Can be viewed as a searchable list or downloaded. bit.ly/glossary_herbs

March 2018 • HEPATITIS SA COMMUNITY NEWS 77

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íñþĄ Ąÿ ÷õĄ ÿŀ Ąøõ ýõĂĂĉ«÷ÿ«Ăÿąþô

Free, after-hours support is available for anyone struggling with addictive behaviour.

The SMART (Self Management and Recovery Training) Recovery group meetings run for 90 minutes each Wednesday, from 5.30PM at 3 Hackney Road, Hackney, in the meeting room at the rear of Hepatitis SA. The program can assist with any problematic behaviours, including addiction to drugs, alcohol, cigarettes, gambling, food, shopping, internet and others. Focus is upon the addictive behaviour, not the substance itself.

Participants are guided by trained peers and professionals, to help themselves and help each other using a variety of cognitive behaviour therapy (CBT) and motivational tools and techniques. Identifying the pros and cons of the

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problematic behaviour, recognising triggers, beliefs and consequences, evaluating areas of importance and setting achievable goals.

These tools and techniques ñĂõ ĀĂÿĆõþ Ąÿ òõ õŀõóĄùĆõ ùþ building and maintaining motivation for the desired changes in behaviour. They assist in coping with cravings or urges. They provide problem solving techniques and help with achieving lifestyle balance and personal goals. The goals are selfùôõþĄùŁõô ĂõñüùăĄùó ñþô achievable.

Attending SMART Recovery meetings each week ensures that people come with a purpose and leave with a plan to manage their own addictive behaviour.

For more information, call Lisa on 8362 8443, or visit smartrecoveryaustralia.com. au.

HEPATITIS SA COMMUNITY NEWS 77 • March 2018

Smoking People with hepatitis C in the US are at least three times more likely to smoke than the general population but little is being done to help them stop smoking, and US researchers argue in the American Journal of Medicine that it is folly to spend huge sums on hepatitis C treatment without also trying to help patients stop smoking.

Smoking contributes to ĄøĂõõ ÿö Ąøõ ŁĆõ üõñôùþ÷ causes of death in Western countries: heart disease, stroke and cancer. Hepatitis C independently increases the risk of cardiovascular disease, liver cancer and cancers of the head, neck, lung, pancreas, kidney and anorectum.

A study of nearly 44,000 adults found that those with hepatitis C were three times more likely to smoke, and smokers with hepatitis C ćõĂõ ăù÷þùŁóñþĄüĉ ýÿĂõ üùûõüĉ to be black, poor, and have less education compared to smokers without hepatitis C. Among smokers, those with hepatitis C were more likely to be daily smokers, and had smoked for longer.

Depression was more frequent ñýÿþ÷ ăýÿûõĂă°ñþô ñüü ĀõÿĀüõ° ćùĄø øõĀñĄùĄùă Ù and both these groups also øñô ăù÷þùŁóñþĄüĉ øù÷øõĂ depression compared to people without hepatitis C. Though Australia has a public health system that puts the US to shame, many other factors found in the US are likely to apply here as well, and comparable research needs to be done.

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

Hutt St Centre Showers, laundry facilities, visiting health professionals, recreation activities, education and training, legal aid and assistance services provided to the homeless.

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

258 Hutt St, Adelaide SA 5000 (08) 8418 2500

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

Lifeline National, 24-hour telephone counselling service.

(08) 8351 7626

Adelaide Dental Hospital A specially funded clinic provides priority dental care for people with hepatitis C with a Health Care Card.

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

SAMESH South Australia Mobilisation + Empowerment for Sexual Health www.samesh.org.au

Call Hepatitis SA on 1800 437 222 for a referral.

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

(08) 8362 8443 admin@hepatitissa.asn.au www.hepsa.asn.au Hepatitis SA Helpline 1800 437 222 (cost of a local call)

beyondblue Mental health information line 1300 224 636 www.beyondblue.org.au Clean Needle Programs in SA For locations visit the Hepatitis SA Hackney office or call the Alcohol and Drug Information Service.

1300 131 340 Community Access & Services SA Alcohol and drug education; clean needle program for the Vietnamese and other communities.

(08) 8447 8821 headspace Mental health issues are common.

Find information, support and help at your local headspace centre 1800 650 890 www.headspace.org.au

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.

(08) 8245 8100

Youth Health Service Free, confidential health service for youth aged 12 to 25.

Youth Helpline: 1300 13 17 19 Parent Helpline: 1300 364 100 Vincentian Centre Men’s night shelter run by St Vincent de Paul Society.

Assistance hotline: 1300 729 202

(08) 8406 1600 Viral Hepatitis Community Nurses Care and assistance, education, streamlined referrals, patient support, work-up for HCV treatment, monitoring and follow-ups. Clients can self-refer. Contact nurses directly for an appointment.

Central

Margery - 0423 782 415 margery.milner@sa.gov.au Jeff - 0401 717 953 North

Lucy - 0401 717 971 Michelle - 0413 285 476 South

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

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HEPATITIS SA COMMUNITY NEWS 77 • March 2018