“Positively Hep” – A Multidisciplinary Incentivised Hepatitis C Program For Disadvantaged Communities

Author: Maher L, Benson S, Bridges-Webb I, Downie J, Jackson E, Luo J, Page J

Theme: Models of Care Year: 2018

Background: Chronic hepatitis C is a prevalent condition in intravenous substance users, affecting 80,700 people in New South Wales and 230,000 people around Australia as of 20161 . Since the PBS listed direct-acting antivirals (DAA) in March 2016, over 40,000 people have initiated treatment. However, people from disadvantaged communities are poorly represented in this due to barriers to accessing mainstream health services. Description of model of care/intervention: The Positively Hep intervention is a multidisciplinary hepatitis C project, delivered by the Needle and Syringe Program (NSP), Sexual Health and the Liver Clinics at Nepean Hospital in outer western Sydney. It offers small monetary incentives for participants’ involvement in education, screening, testing and treatment. Participants are also encouraged to inform their communities and refer peers to the service. Clinical staff provide healthcare through a walkin service at the Nepean NSP, with support from a peer worker. The program has been running since March 2016. Effectiveness: Of 319 participants who received education initially, 145 (45%) were screened and 71/145 (49%) were found to have chronic hepatitis C. In participants with hepatitis C, 32 (51%) underwent transient elastography (FibroScan) and 22 (35%) underwent treatment. To date, 21 (95%) of those being treated have completed their DAA regime. Conclusion and next steps: An incentivised program for education, screening, peer support, and treatment of chronic hepatitis C is effective, and has the potential to reach at-risk individuals in disadvantaged communities that may not access mainstream health services. Disclosure of Interest Statement: The authors declare no conflict of interest.

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