TOWARDS OPTIMISING CARE AND PREVENTION FOR PEOPLE WHO INJECT DRUGS, AND LIVING WITH HIV AND VIRAL HEPATITIS IN MELBOURNE, AUSTRALIA – EVALUATION OF AN INTEGRATED HIV AND HOMELESSNESS NURSING SERVICE


Author: Crock EA, Rushford MA

Theme: Epidemiology & Public Health Research Year: 2019

Background: The HIV Nursing Program (HIVP) at Bolton Clarke (BC) in Melbourne, Australia was
established in 1985, evolving to meet changing needs of people living with HIV (PLHIV). HIVP clients
include long-term survivors, refugees/asylum seekers, people who inject drugs (PWID), newly
diagnosed, and people experiencing homelessness.
In 2015, the HIVP was integrated with BC’s Homeless Persons Program (HPP). HPP provides health
care and harm minimization to people experiencing homelessness within a social model of health. It
is also a registered needle and syringe program. Program integration aims to increase access to
HIVP, including for PWID and PLHIV/HCV co-infection. We conducted an outcome evaluation of the
integration as a quality improvement project.
Methods: In 2018, we undertook an internal outcome evaluation using mixed methods. Data were
collected from:
1. HIVP reporting data (2007-18);
2. A staff survey. We designed a questionnaire using Survey Monkey© to evaluate client and
staff outcomes;
3. Case studies of clients living with HIV and HCV.
We analyzed survey data using Survey Monkey’s in-built tools. Qualitative data were thematically
analyzed.
Results:
1. HIVP data indicates the HIVP’s reach has extended since integration. Average number of
admissions (2007- 2014) – 241. Since integration (2015 – mid-2018) – 351.
2. 43/58 staff responded to the survey (74%). Respondents indicated Program integration
contributes to client outcomes through flexible, holistic models of care, primary health care
and shared resources. There is increased capacity to engage marginalized clients, and high
staff satisfaction.
3. Case study reviews demonstrate effective HIV viral suppression, HCV cure and harm
minimization education.
Conclusion:
HIVP and HPP integration demonstrates positive client and staff outcomes. We found increased
access to and engagement in care for people from marginalized backgrounds including PWID living
with HIV/HCV. Development of, and research into the model could link with broader research
through additional Partnerships.
Disclosure of Interest Statement: The authors declare no conflicts of interest. No pharmaceutical
grants were received in the development of this study.

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