The Next Step in Collaborative HCV Care – PWID, Partnerships and Potential to Treat


Author: J Bourke, C Henderson

Theme: Social Science & Policy Research Year: 2015

Background
The Christchurch Hepatitis C Community Clinic (HCCC) successfully provides HCV care through testing, diagnosis, assessment, monitoring and referral into antiviral therapy. Under the auspices of Needle Exchange New Zealand and in collaboration with the Rodger Wright Centre (RWC) the Clinic operates to increase access to HCV care for PWID. The Clinic’s focus is on working with PWID to mentor them through their HCV journey. The service, therefore, also provides outreach into Alcohol and Drug services (including OST) and receives referrals from the Sexual Health Centre, GP’s, AIDs Foundation, corrections, NZ Prostitutes Collective and social service agencies. The Clinic also works closely with secondary care in supporting clients through treatment.

Methods
This paper presents a descriptive analysis of service and client data collected by the HCCC. It presents data to inform the need for this model of care to be transferred to other needle exchanges in other regional centres through a collaborative national initiative. Key aspects of this model of service delivery are also examined in relation to: ‘hub and spoke’ structure, rapid testing and PWID pathways and potential to treat.

Results
Although HCV exposure has reduced significantly among PWID, current HCV modelling shows 1000 new HCV infections annually. HCV modelling data in New Zealand indicates there are 53,000 chronically infected with HCV. The Clinic has a diagnostic positivity rate of 35.68% HCV RNA in enrolled clients with a 92% attendance rate at secondary care first specialist appointment. A third of those referred for specialist treatment in Canterbury are referred by the Clinic.

Conclusions
The HCCC improves hepatitis C health care by providing a non- judgemental and holistic model of care. Transferring this model to other regional centres through collaboration with needle exchanges will improve access to care for PWID. The potential to treat PWID ‘where they live’ has huge potential for the future.

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