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Uthurralt N, McGlinn A, O'Donnell M, Haber PS, Day CA. The impact of a 24-hour syringe dispensing machine on a face-to-face needle and syringe program and targeted primary healthcare clinic. Aust N Z J Public Health 2022; 46:524-526. [PMID: 35679052 DOI: 10.1111/1753-6405.13267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/01/2022] [Accepted: 04/01/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Automatic syringe dispensing machines (ADM) have become an important adjunct to Australia's needle and syringe programs (NSP). However, concerns that they reduce face-to-face contact with health staff and other health interventions remain. We examined changes in the number of needle/syringes dispensed at an ADM and occasions of service at a co-located face-to-face NSP and targeted primary healthcare clinic during the first wave of COVID-19 restrictions. METHODS We reviewed data from an inner-city harm reduction program during the study period of April 2020 to March 2021 compared to the previous year. Multivariable linear regression models were used to estimate the association between occasions of service and equipment distribution. RESULTS ADM-dispensed equipment increased significantly by 41.1%, while face-to-face NSP occasions decreased by 16.2%. Occasions provided by the targeted primary healthcare clinic increased by 59.7% per month. CONCLUSION We have shown that 24-hour ADM access did not adversely affect the number of people using targeted primary healthcare when provided within close proximity. Implication for public health: These findings reinforce the demand for 24-hour needle/syringe access and can be used to support the expanded access to ADMs, especially where people who inject drugs (PWID) have access to appropriate healthcare.
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Affiliation(s)
- Natalia Uthurralt
- Drug Health Services, Sydney Local Health District, New South Wales.,Specialty of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, New South Wales
| | - Anica McGlinn
- Drug Health Services, Sydney Local Health District, New South Wales
| | - Martin O'Donnell
- Drug Health Services, Sydney Local Health District, New South Wales.,Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Sydney Local Health District, New South Wales
| | - Paul S Haber
- Drug Health Services, Sydney Local Health District, New South Wales.,Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Sydney Local Health District, New South Wales.,Specialty of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney, New South Wales
| | - Carolyn A Day
- Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Sydney Local Health District, New South Wales
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2
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Malaguti A, Sani F, Stephens BP, Ahmad F, Dugard P, Dillon JF. Change in injecting behaviour among people treated for hepatitis C virus: The role of intimate partnerships. J Viral Hepat 2019; 26:65-72. [PMID: 30260560 DOI: 10.1111/jvh.13009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 09/07/2018] [Indexed: 12/12/2022]
Abstract
Injecting behaviour in people who inject drugs is the main risk factor for hepatitis C virus (HCV) infection. Psychosocial factors such as having a partner who injects drugs and living with other drug users have been associated with increases in injecting risk behaviour. This study aimed to investigate changes in injecting behaviour during treatment for HCV infection whilst exploring the role of psychosocial factors on patients' injecting behaviour. Eradicate-C was a single-centred clinical trial (ISRCTN27564683) investigating the effectiveness of HCV treatment within the injecting drug-using population between 2012 and 2017. A total of 94 participants completed up to 24 weeks of treatment, with social and behavioural measures taken at different intervals throughout treatment. Data for 84 participants were analysed retrospectively to explore mechanisms of potential behavioural changes which had occurred during treatment. Injecting frequency reduced significantly between baseline (week 1) and every 4-weekly interval until week 26. Not being on opiate substitution therapy (OST) was associated with a statistically significant decrease in injecting frequency, χ2 (1) = 10.412, P = 0.001, as was having a partner who also used drugs, in particular when that partner was also on treatment for HCV infection, Z = -2.312, P = 0.021. Treating a hard-to-reach population for HCV infection is not only possible, but also bears health benefits beyond treatment of HCV alone. Enrolling couples on HCV treatment when partners are sero-concordant has shown enhanced benefits for reduction in injecting behaviour. Implications for practice are discussed.
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Affiliation(s)
- Amy Malaguti
- School of Social Sciences (Psychology), University of Dundee, Dundee, UK.,Adult Psychological Therapies Service, NHS Tayside, Dundee, UK.,Sexual Health and Blood Borne Virus Managed Care Network, Public Health Directory, NHS Tayside, Kings Cross Hospital, Dundee, UK.,School of Medicine, University of Dundee, Dundee, UK
| | - Fabio Sani
- School of Social Sciences (Psychology), University of Dundee, Dundee, UK
| | - Brian P Stephens
- Department of Gastroenterology, NHS Tayside, Ninewells Hospital, Dundee, UK
| | - Farsana Ahmad
- Department of Gastroenterology, NHS Tayside, Ninewells Hospital, Dundee, UK
| | - Pat Dugard
- School of Social Sciences (Psychology), University of Dundee, Dundee, UK
| | - John F Dillon
- School of Medicine, University of Dundee, Dundee, UK.,Department of Gastroenterology, NHS Tayside, Ninewells Hospital, Dundee, UK
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3
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Development of immunity following financial incentives for hepatitis B vaccination among people who inject drugs: A randomized controlled trial. J Clin Virol 2015; 74:66-72. [PMID: 26679830 DOI: 10.1016/j.jcv.2015.11.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 10/21/2015] [Accepted: 11/25/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND People who inject drugs (PWID) are at risk of hepatitis B virus (HBV) but have low rates of vaccination completion. The provision of modest financial incentives increases vaccination schedule completion, but their association with serological protection has yet to be determined. OBJECTIVE To investigate factors associated with vaccine-induced immunity among a sample of PWID randomly allocated to receive AUD$30 cash following receipt of doses two and three ('incentive condition') or standard care ('control condition') using an accelerated 3-dose (0,7,21 days) HBV vaccination schedule. STUDY DESIGN A randomised controlled trial among PWID attending two inner-city health services and a field site in Sydney, Australia, assessing vaccine-induced immunity measured by hepatitis B surface antibodies (HBsAb ≥ 10 mIU/ml) at 12 weeks. The cost of the financial incentives and the provision of the vaccine program are also reported. RESULTS Just over three-quarters of participants - 107/139 (77%)--completed the vaccination schedule and 79/139 (57%) were HBsAb ≥ 10 mIU/ml at 12 weeks. Vaccine series completion was the only variable significantly associated with vaccine-induced immunity in univariate analysis (62% vs 41%, p<0.035) but was not significant in multivariate analysis. There was no statistically discernible association between group allocation and series completion (62% vs 53%). The mean costs were AUD$150.5, (95% confidence interval [CI]: 142.7-158.3) and AUD$76.9 (95% CI: 72.6-81.3) for the intervention and control groups respectively. CONCLUSION Despite increasing HBV vaccination completion, provision of financial incentives was not associated with enhanced serological protection. Further research into factors which affect response rates and the optimal vaccination regimen and incentive schemes for this population are needed.
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4
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Morgan K, Lee J, Sebar B. Community health workers: A bridge to healthcare for people who inject drugs. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:380-7. [DOI: 10.1016/j.drugpo.2014.11.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 09/17/2014] [Accepted: 11/04/2014] [Indexed: 10/24/2022]
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Nambiar D, Stoové M, Dietze P. A cross-sectional study describing factors associated with utilisation of GP services by a cohort of people who inject drugs. BMC Health Serv Res 2014; 14:308. [PMID: 25030526 PMCID: PMC4110070 DOI: 10.1186/1472-6963-14-308] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 07/08/2014] [Indexed: 11/10/2022] Open
Abstract
Background People who inject drugs (PWID) use healthcare services, including primary care, at a disproportionately high rate. We investigated key correlates of general practitioner (GP) related service utilisation within a cohort of PWID. Methods Using baseline data from a cohort of 645 community-recruited PWID based in Melbourne, Victoria, we conducted a secondary analysis of associations between past month use of GP services unrelated to opioid substitution therapy (OST) and socio-demographic and drug use characteristics and self-reported health using multivariate logistic regression. Results Just under one-third (29%) of PWID had accessed GP services in the month prior to being surveyed. Participants who reported living with children (adjusted odds ratio, AOR 1.97, 95% CI 1.04 - 3.73) or having had contact with a social worker in the past month (AOR 1.92, 95% CI 1.24 - 2.98) were more likely to have seen a GP in the past month. Participants who were injecting daily or more frequently (AOR 0.50, 95% CI 0.30 - 0.83) or had a weekly income of less than $400 (AOR 0.59, 95% CI 0.38 - 0.91) were less likely to report having seen a GP in the past month. Conclusions Our sample frequently attended GP services for health needs unrelated to OST. Findings highlight both the characteristics of PWID accessing GP services and also those potentially missing out on primary care and preventive services.
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Affiliation(s)
- Dhanya Nambiar
- Centre for Population Health, Burnet Institute, 85 Commercial Rd, 3004 Melbourne, VIC, Australia.
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6
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Burr CK, Storm DS, Hoyt MJ, Dutton L, Berezny L, Allread V, Paul S. Integrating health and prevention services in syringe access programs: a strategy to address unmet needs in a high-risk population. Public Health Rep 2014; 129 Suppl 1:26-32. [PMID: 24385646 DOI: 10.1177/00333549141291s105] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Injection drug users are at a high risk for a number of preventable diseases and complications of drug use. This article describes the implementation of a nurse-led health promotion and disease prevention program in New Jersey's syringe access programs. Initially designed to target women as part of a strategy to decrease missed opportunities for perinatal HIV prevention, the program expanded by integrating existing programs and funding streams available through the state health department. The program now offers health and prevention services to both men and women, with 3,488 client visits in 2011. These services extend the reach of state health department programs, such as adult vaccination and hepatitis and tuberculosis screening, which clients would have had to seek out at multiple venues. The integration of prevention, treatment, and health promotion services in syringe access programs reaches a vulnerable and underserved population who otherwise may receive only urgent and episodic care.
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Affiliation(s)
- Carolyn K Burr
- Rutgers, The State University of New Jersey, School of Nursing, François-Xavier Bagnoud Center, Newark, NJ
| | - Deborah S Storm
- Rutgers, The State University of New Jersey, School of Nursing, François-Xavier Bagnoud Center, Newark, NJ
| | - Mary Jo Hoyt
- Rutgers, The State University of New Jersey, School of Nursing, François-Xavier Bagnoud Center, Newark, NJ
| | - Loretta Dutton
- New Jersey Department of Health, Division of HIV, STD and TB Services, Trenton, NJ
| | - Linda Berezny
- New Jersey Department of Health, Division of HIV, STD and TB Services, Trenton, NJ
| | - Virginia Allread
- Rutgers, The State University of New Jersey, School of Nursing, François-Xavier Bagnoud Center, Newark, NJ
| | - Sindy Paul
- New Jersey Department of Health, Division of HIV, STD and TB Services, Trenton, NJ
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Topp L, Day CA, Wand H, Deacon RM, van Beek I, Haber PS, Shanahan M, Rodgers C, Maher L. A randomised controlled trial of financial incentives to increase hepatitis B vaccination completion among people who inject drugs in Australia. Prev Med 2013; 57:297-303. [PMID: 23639625 DOI: 10.1016/j.ypmed.2013.04.013] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 04/11/2013] [Accepted: 04/15/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study aimed to investigate the efficacy of modest financial incentives in increasing completion of an accelerated 3-dose hepatitis B virus (HBV) vaccination schedule (0, 7, 21days) among people who inject drugs (PWID). METHODS Randomised controlled trial. Participants were randomly allocated to receive $30 Australian Dollars cash following receipt of vaccine doses two and three ('incentive condition'), or standard care ('control condition'). Serologically confirmed HBV-susceptible PWID. Two inner-city health services and a field study site in Sydney, Australia. The primary outcome was completion of the vaccination series. Additional assessments included self-reported demographic, drug use and treatment, and risk-taking histories. RESULTS Compared to the control condition, significantly more participants in the incentive condition received all three vaccine doses, under intention-to-treat analyses (n=139; 87% versus 66%; p=.004); and within the specified window periods under per protocol analyses (n=107 received three vaccine doses; 92% versus 67%; p=.001). Multivariate analysis indicated that the incentive condition and longer injecting histories significantly increased the likelihood of series completion. Aboriginal/Torres Strait Islanders were significantly less likely to complete the series. CONCLUSIONS Modest financial incentives, per-dose, increased adherence to the accelerated HBV vaccination schedule among PWID. Results have implications for increasing HBV and, potentially, other vaccine-preventable infections, among PWID.
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Affiliation(s)
- Libby Topp
- The Kirby Institute, University of New South Wales, NSW 2052, Australia
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8
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Horyniak D, Dietze P, Degenhardt L, Higgs P, McIlwraith F, Alati R, Bruno R, Lenton S, Burns L. The relationship between age and risky injecting behaviours among a sample of Australian people who inject drugs. Drug Alcohol Depend 2013; 132:541-6. [PMID: 23664499 DOI: 10.1016/j.drugalcdep.2013.03.021] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 03/28/2013] [Accepted: 03/30/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Limited evidence suggests that younger people who inject drugs (PWID) engage in high-risk injecting behaviours. This study aims to better understand the relationships between age and risky injecting behaviours. METHODS Data were taken from 11 years of a repeat cross-sectional study of sentinel samples of regular PWID (The Australian Illicit Drug Reporting System, 2001-2011). Multivariable Poisson regression was used to explore the relationship between age and four outcomes of interest: last drug injection occurred in public, receptive needle sharing (past month), experiencing injecting-related problems (e.g. abscess, dirty hit; past month), and non-fatal heroin overdose (past six months). RESULTS Data from 6795 first-time study participants were analysed (median age: 33 years, interquartile range [IQR]: 27-40; median duration of injecting: 13 years [IQR: 7-20]). After adjusting for factors including duration of injecting, each five year increase in age was associated with significant reductions in public injecting (adjusted incidence rate ratio [AIRR]: 0.90, 95% confidence interval [CI]: 0.88-0.92), needle sharing (AIRR: 0.84, 95% CI: 0.79-0.89) and injecting-related problems (AIRR: 0.96, 95% CI: 0.95-0.97). Among those who had injected heroin in the six months preceding interview, each five year increase in age was associated with an average 10% reduction in the risk of heroin overdose (AIRR: 0.90, 95% CI: 0.85-0.96). CONCLUSIONS Older PWID report significantly lower levels of high-risk injecting practices than younger PWID. Although they make up a small proportion of the current PWID population, younger PWID remain an important group for prevention and harm reduction.
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Affiliation(s)
- D Horyniak
- Centre for Population Health, Burnet Institute, Melbourne, Victoria 3004, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia.
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9
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Dawson A, Jackson D. The primary health care service experiences and needs of homeless youth: a narrative synthesis of current evidence. Contemp Nurse 2013; 44:62-75. [PMID: 23721389 DOI: 10.5172/conu.2013.44.1.62] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Homeless youth are a growing, vulnerable population with specific primary health care (PHC) requirements. There are no systematic reviews of evidence to guide the delivery of PHC interventions to best address the needs of homeless youth in Australia. We present a narrative synthesis of peer reviewed research designed to determine: (1) the PHC services homeless youth access; (2) experiences of services, reported outcomes and barriers to use; and, (3) the PHC service needs of homeless youth. Findings show that homeless youth access a variety of services and delivery approaches. Increased PHC use is associated with youth who recognise they need help. Street-based clinic linked services and therapy and case management alongside improved housing can positively impact upon mental health and substance use outcomes. Barriers to service use include knowledge; provider attitudes, financial constraints and inappropriate environments. Findings support targetted, co-ordinated networks of PHC and housing services with nurses working alongside community workers.
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Affiliation(s)
- Angela Dawson
- Health Services and Practice Research Group, University of Technology, Sydney, NSW, Australia
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10
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Islam MM, Topp L, Iversen J, Day C, Conigrave KM, Maher L. Healthcare utilisation and disclosure of injecting drug use among clients of Australia's needle and syringe programs. Aust N Z J Public Health 2013; 37:148-54. [DOI: 10.1111/1753-6405.12032] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Islam MM, Shanahan M, Topp L, Conigrave KM, White A, Day CA. The cost of providing primary health-care services from a needle and syringe program: a case study. Drug Alcohol Rev 2012. [PMID: 23194468 DOI: 10.1111/dar.12019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS Targeted primary health-care services for injecting drug users have been established in several countries to reduce barriers to health care, subsequent poor health outcomes and the considerable costs of emergency treatment. The long-term sustainability of such services depends on the resources required and the coverage provided. This study assesses the additional cost required to operate a nurse-led primary health care in an existing needle syringe program setting, estimates the costs per occasion of service and identifies key factors influencing improved service utilisation. DESIGN AND METHODS Using standard costing methods and the funder perspective, this study estimates costs using the 'ingredients' approach where the costs of inputs are based on quantities and unit prices (the ingredients). RESULTS During the 2009-2010 fiscal year, the primary health-care clinic provided 1252 occasions of service to 220 individuals, who each made an average of 3.9 presentations. A total cost of AU$250,626 was incurred, 69% of which was for personnel and 22% for pathology. During the study period the average cost per occasion of service was AU$199.96, which could be as low as AU$93.32 if the clinic reached its full utilisation level. DISCUSSION AND CONCLUSIONS Although the average number of presentations per client was satisfactory, the clinic was underutilised during the study period. Proactive engagement of clients at the needle syringe program shopfront and an increased range of services offered by the clinic may help to attract more clients.
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Affiliation(s)
- M Mofizul Islam
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
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Deacon RM, Topp L, Wand H, Day CA, Rodgers C, Haber PS, van Beek I, Maher L. Correlates of susceptibility to hepatitis B among people who inject drugs in Sydney, Australia. J Urban Health 2012; 89:769-78. [PMID: 22684422 PMCID: PMC3462823 DOI: 10.1007/s11524-012-9680-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Despite a safe, effective vaccine, hepatitis B virus (HBV) vaccination coverage remains low among people who inject drugs (PWID). Characteristics of participants screened for a trial investigating the efficacy of financial incentives in increasing vaccination completion among PWID were examined to inform targeting of vaccination programs. Recruitment occurred at two health services in inner-city Sydney that target PWID. HBV status was confirmed via serological testing, and questionnaires elicited demographic, drug use, and HBV risk data. Multinomial logistic regression was utilized to determine variables independently associated with HBV status. Of 172 participants, 64% were susceptible, 17% exposed (HBV core antibody-positive), and 19% demonstrated evidence of prior vaccination (HBV surface antibody ≥ 10 mIU/ml). Compared with exposed participants, susceptible participants were significantly more likely to be aged less than 35 years and significantly less likely to be receiving current opioid substitution therapy (OST) and to test hepatitis C antibody-positive. In comparison to vaccinated participants, susceptible participants were significantly more likely to be male and significantly less likely to report daily or more frequent injecting, current OST, and prior awareness of HBV vaccine. HBV vaccination uptake could potentially be increased by targeting younger, less frequent injectors, particularly young men. In addition to expanding vaccination through OST, targeting "at risk" youth who are likely to have missed adolescent catch-up programs may be an important strategy to increase coverage. The lack of an association between incarceration and vaccination also suggests increasing vaccination uptake and completion in adult and juvenile correctional facilities may also be important.
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Affiliation(s)
- Rachel M Deacon
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
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13
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Islam MM, Topp L, Conigrave KM, White A, Reid SE, Grummett S, Haber PS, Day CA. Linkage into specialist hepatitis C treatment services of injecting drug users attending a needle syringe program-based primary healthcare centre. J Subst Abuse Treat 2012; 43:440-5. [PMID: 22938915 DOI: 10.1016/j.jsat.2012.07.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 05/15/2012] [Accepted: 07/02/2012] [Indexed: 01/18/2023]
Abstract
Injecting drug users (IDUs), the key risk population for hepatitis C virus (HCV) infection, constitute just a small proportion of HCV treatment clients. This study describes an HCV treatment assessment model developed by an inner-city IDU-targeted primary healthcare (PHC) facility and, using a retrospective clinical audit, documents predictors of successful referrals to a tertiary liver clinic. Between July 2006-December 2010, 479 clients attended the PHC, of whom 353 (74%) were screened for HCV antibody. Sixty percent (212/353) tested positive, of whom 93% (197/212) were screened for HCV-RNA with 73% (143/197) positive. Referrals to a tertiary liver clinic were provided to 96 clients, of whom 68 (71%) attended. Eleven clients commenced antiviral therapy (AVT), with seven achieving sustained virological responses by December 2010. Clients who had not recently injected drugs and those with elevated ALT levels were more likely to attend the referrals, while those not prescribed psychiatric medications were more likely to commence AVT. The relatively high uptake of referrals, the number of individuals commencing AVT and final treatment outcomes are reasonably encouraging, highlighting the potential of targeted PHC services to facilitate reductions in liver disease burden among IDUs.
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Affiliation(s)
- M Mofizul Islam
- School of Public Health and Community Medicine, University of New South Wales, Australia
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Islam MM, Topp L, Conigrave KM, Day CA. Opioid substitution therapy clients' preferences for targeted versus general primary health-care outlets. Drug Alcohol Rev 2012; 32:211-4. [DOI: 10.1111/j.1465-3362.2012.00498.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 08/02/2012] [Indexed: 11/29/2022]
Affiliation(s)
| | - Libby Topp
- Viral Hepatitis Epidemiology and Prevention Program; The Kirby Institute; University of New South Wales; Sydney; Australia
| | | | - Carolyn A. Day
- Discipline of Addiction Medicine; Central Clinical School (C39); University of Sydney; Sydney; Australia
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Callaghan P, Phillips P, Khalil E, Carter T. Meeting the physical health-care needs of people with substance misuse problems: evaluation of a nurse-led blood-borne virus programme. Int J Ment Health Nurs 2012; 21:248-58. [PMID: 22533332 DOI: 10.1111/j.1447-0349.2012.00822.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
People who inject substances are at high risk of many physical health problems. The Blood-Borne Virus Programme (BBVP) is a nurse-led health screening programme for blood-borne conditions in substance misusers. The aim of this study was to evaluate the service delivery, organization, and outcomes of the BBVP. The researchers used a case study with three units of analysis: BBVP clinical activities during 1 year using a prospective audit; service users' (n = 20) and professional stakeholders' (n = 10) experiences of the BBVP using semistructured interviews; and service users' (n = 132) satisfaction with the BBVP using a satisfaction measure. The BBVP conducted 4450 consultations with 1940 service users; 847 of whom were new, and presented with many health problems compromising their physical health. The BBVP provided a range of interventions meeting its users' physical health needs. Users and other stakeholders were very satisfied with the service, and suggested ways in which the service might improve. The BBVP appeared to meet the physical health-care needs of people dependent on drugs. Nurse-led services, such as the BBVP, offer a solution that, in the view of users and professional stakeholders, is impacting significantly on the physical health and well-being of people dependent on drugs.
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Affiliation(s)
- Patrick Callaghan
- School of Nursing, Midwifery and Physiotherapy, University of Nottingham, Nottingham, UK.
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Islam MM, Topp L, Conigrave KM, van Beek I, Maher L, White A, Rodgers C, Day CA. The reliability of sensitive information provided by injecting drug users in a clinical setting: Clinician-administered versus audio computer-assisted self-interviewing (ACASI). AIDS Care 2012; 24:1496-503. [PMID: 22452446 DOI: 10.1080/09540121.2012.663886] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M. Mofizul Islam
- a School of Public Health & Community Medicine , University of New South Wales , Sydney , Australia
- b Drug Health Service , Royal Prince Alfred Hospital , Sydney , Australia
| | - Libby Topp
- c The Kirby Institute (formerly the National Centre in HIV Epidemiology and Clinical Research) , University of New South Wales , Sydney , Australia
| | - Katherine M. Conigrave
- b Drug Health Service , Royal Prince Alfred Hospital , Sydney , Australia
- d Sydney Medical School , University of Sydney , Sydney , Australia
- e National Drug and Alcohol Research Centre , University of New South Wales , Sydney , Australia
| | | | - Lisa Maher
- c The Kirby Institute (formerly the National Centre in HIV Epidemiology and Clinical Research) , University of New South Wales , Sydney , Australia
| | - Ann White
- g Redfern Harm Minimisation Clinic , Local Health District, Sydney , Australia
| | | | - Carolyn A. Day
- d Sydney Medical School , University of Sydney , Sydney , Australia
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Myers BJ. Primary health care for people who inject drugs in low and middle income countries. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2012; 23:105-6. [DOI: 10.1016/j.drugpo.2011.09.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 09/28/2011] [Indexed: 10/15/2022]
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The accessibility, acceptability, health impact and cost implications of primary healthcare outlets that target injecting drug users: a narrative synthesis of literature. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2011; 23:94-102. [PMID: 21996165 DOI: 10.1016/j.drugpo.2011.08.005] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2011] [Revised: 08/08/2011] [Accepted: 08/17/2011] [Indexed: 11/21/2022]
Abstract
BACKGROUND Injecting drug users (IDUs) are at increased risk of health problems ranging from injecting-related injuries to blood borne viral infections. Access to primary healthcare (PHC) is often limited for this marginalised group. Many seek care at emergency departments and some require hospital admission due to late presentation. The costs to both the individual and the health system are such that policymakers in some settings have implemented IDU-targeted PHC centres, with a number of models employed. However, there is insufficient evidence on the effectiveness of these centres to inform health service planning. A systematic review examining such interventions is not possible due to the heterogeneous nature of study designs. Nevertheless, an integrative literature review of IDU-targeted PHC may provide useful insights into the range of operational models and strategies to enhance the accessibility and acceptability of these services to the target population. METHODS Available literature describing the impact of IDU-targeted PHC on health outcomes, cost implications and operational challenges is reviewed. A narrative synthesis was undertaken of material sourced from relevant journal publications, grey literature and policy documents. RESULTS Several models have proven accessible and acceptable forms of PHC to IDUs, improving the overall healthcare utilisation and health status of this population with consequent savings to the health system due to a reduction in visits to emergency departments and tertiary hospitals. CONCLUSIONS Although such findings are promising, there remains a dearth of rigorous evaluations of these targeted PHC, with the public health impact of such outlets yet to be systematically documented.
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Islam MM, Grummett S, White A, Reid SE, Day CA, Haber PS. A primary healthcare clinic in a needle syringe program may contribute to HIV prevention by early detection of incident HIV in an injecting drug user. Aust N Z J Public Health 2011; 35:294-5. [DOI: 10.1111/j.1753-6405.2011.00708.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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