AIDS 2018: Safe injecting sites open public health opportunities across Europe

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Science Speaks is covering the 22nd International AIDS Conference this week live from Amsterdam, the Netherlands, with breaking news, updates and analysis of new research findings, evidence-based responses, and community action for global access to HIV treatment and prevention.

AMSTERDAM – A man who came to the Uniting Medically Supervised Injection Centre at Kings Cross in the epicenter of Sydney Australia’s conjoined epidemics of infectious diseases and opioid use, was in his late 30s, homeless, with a long history of injecting drugs, and of hepatitis C infection. Seizures, as many as several a week, frequently landed him in hospitals, with broken bones, bleeding, and memory loss, but he never kept appointments for medical services. The one place he reliably showed up, two or three times a day, in fact, was the place where he could inject drugs safely, without risk of overdose, of catching another infection, or transmitting his.

He was one of 2,000 people, hard to reach through other public health approaches, who visit the site yearly, and because he did, his hepatitis C infection is cured and won’t be transmitted by him to anyone else. In the process, he received consistent medication for his seizures, and no longer afraid of having one when alone, is off the streets. His story, according to Eberhard Schatz of Correlation European Harm Reduction Network, reflects one of many opportunities being seized across Europe to address hepatitis C and other public health threats at drug consumption rooms and supervised injection sites. Schatz presented findings from online surveys that give a picture of a range of services, with a focus on hepatitis C responses, offered at 49 such sites in Australia, Canada, Denmark, France, Germany, Luxembourg, Netherlands, Norway, Spain and Switzerland, representing every country with at least drug consumption room.

About 80 percent of the supervised injection sites, or drug consumption rooms, are staffed with a nurse, 78 percent with a social worker, and about 43 percent have a physician on site, the survey showed. Health educators offer information at 28 percent of the sites. Hepatitis C related education — including information on transmission routes, symptoms, testing and treatment — is available at 94 percent of the sites, and 96 percent provide referrals. On-site testing for hepatitis C is offered at 30 of the 49 sites, a service that was taken up by 72 percent of clients across them, and about 60 percent tested positive for the virus.

The site in Sydney is not one of the three sites offering treatment for hepatitis C on the premises, but still, staff there secured medication — for seizures as well as for the virus — for its homeless client to administer to himself, and that was effective.

The survey also asked site staff how they would use additional funds if available. More than half said they would hire additional medical staff, nearly half said they would provide more staff training, a quarter would employ peer workers.

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