Theme: Models of Care Year: 2024
Background: Justice Health NSW (JHNSW) has developed a unique set of data to track ongoing Hepatitis C (HCV) transmission in a prison setting post cure. Despite an impressive scale up of HCV testing and treatment our data illustrates more must be done to strengthen harm reduction and better protect people in our care from repeated HCV infections. The NSW custodial setting was historically a world leader in prison harm reduction. This presentation will lead the conversation on best preventive health practice approaches to HCV in closed settings.
Description of model of care/intervention/program:
In 2016 Direct Acting Antiviral (DAA) treatment for HCV became available to people in Australian Prisons. Since then, a comprehensive DAA program has provided 7002 treatments as of February 2024. JHNSW has developed a robust process to identify individuals receiving multiple DAA treatments, clinically review these occurrences to identify new infections and link them to relevant demographic and custodial data items.
Effectiveness: JHNSW has clinically confirmed 1621 instances of re-treatment for HCV, with 1167 new infections post cure. 304 people have been treated three times, followed by 64 treated four times. 13 people have received five treatments and two received six treatments. 466 individuals acquired these new infections while inside a NSW Prison, and 20 people have been identified acquiring a new HCV infection twice during the one custodial sentence.
Aboriginal and Torres Strait Islander people are shockingly overrepresented in the retreatment data representing about 60% of all reinfections.
Conclusion and next steps: New HCV infections occurring in NSW prisons demonstrate that despite efforts to strengthen access to disinfectants, education and Opiate Agonist Therapy more needs to be done to bolster Harm Reduction. Strategies that better engage with and protect Aboriginal and Torres Strait islander people from HCV in Australian prisons must be a priority.