Author: Clark N, Elmore K, Hiley S, Pemberton D, Stothers L, Cogger S, Thomson A

Theme: Clinical Research Year: 2019

Background: North Richmond has long been Melbourne the centre of injecting drug use in
Melbourne. Melbourne’s first Medically Supervised Injecting Room (MSIR) opened in North
Richmond on June 30, 2018, and sees approximately 200 visitors on an average day, and manages
100 overdoses a month. The people who visit the room have multiple complex health and social
needs which are not being met by existing health care services, despite a willingness for people to
receive such treatment. In order to meet its 2030 targets for the elimination of hepatitis C, Australia
needs to detect and treat hepatitis C in people who are injecting drugs. As the medically supervised
injecting room in based in a community health centre, it provides a perfect opportunity for the
testing and treatment of hepatitis C in its clients.
Methods: Initial efforts for testing and treatment of hepatitis was based on referral to the adjacent
community health service. Subsequently a protocol was developed for the opportunistic testing and
treatment within the injecting room itself, with a simplified pathway to maximise DAA uptake. At a
later stage a dedicated nurse for testing and treating hepatitis was present 2 days a week to increase
the uptake of testing and treatment.
Results: The initial protocol of referring to the health centre 20m away way only minimally
successful, with only 10% of those referred attending for testing. Opportunistic testing and
treatment in the room was more successful with 45 tested, 15 needing treatment and 15 treatment
initiated in three months of that approach. The presence of a nurse dedicated for testing and
treatment further increased uptake, and after a further 2 months of the streamlined, on-site model
of care, 200 people had been tested for hepatitis C and 40 had initiated treatment. When a nurse is
available to offer testing and counselling, an average of 2 new cases of hepatitis C are diagnosed
every day. Focus is now on supporting clients to complete treatment. First 12 month data will be
presented, including lessons learned for delivery of hepatitis testing and treatment within a drug
consumption facility.
Conclusion: Low threshold services for people who inject drugs can provide a range of health care
solutions for difficult-to-treat populations. Streamlining those treatment pathways increases
treatment uptake. As well as treating overdose, they can be centres for distributing naloxone,
testing and treatment for BBVs and assessing and treating oral health problems.
Disclosure of Interest: none

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