headline

1
(No Transcript)
2
(No Transcript)
3
(No Transcript)
4
(No Transcript)
5
(No Transcript)
6
(No Transcript)
7
(No Transcript)
8
(No Transcript)
9
(No Transcript)
10
(No Transcript)
11
(No Transcript)
12
(No Transcript)
13
(No Transcript)
14
(No Transcript)
15
(No Transcript)
16
(No Transcript)
17
(No Transcript)
18
(No Transcript)
19
Review of the Literature

• Gifford, S. et al. Australian womens experiences
  of living with HCV Results from a
  cross-sectional survey, Journal of
  Gastroentorology Hepatology (2003) 18, 841-850.
• Only 17 of sample reported receiving pre post
  test counselling.
• 55 said they would have like to have received
  more information when diagnosed.
• Only 1/3 were satisfied with the way they
  received their diagnosis.
• Authors suggest place where diagnosis is given
  and by whom is less important than length of
  consultation time.

20
Review of the Literature

• Rodger, A. et al. The Impact of Diagnosis of HCV
  on Quality of Life, (1999) Hepatology Vol.30,
  No.5, 1299-1301.
• Group aware of HCV status scored significantly
  lower in 7/8 scales (SF36) compared with
  population norms.
• Group unaware of HCV status scored significantly
  lower in 3 scales.
• Authors suggest appropriate and sensitive
  management of diagnosis may help to reduce
  negative effects of diagnosis.

21
Review of the Literature

• Gill, M. et al. Psychological Implications of HCV
  diagnosis, Journal of Gastroentorology
  Hepatology (2005), 20, 1741-1744.
• 32.65 had symptoms consistent with moderate
  anxiety.
• 16.32 had symptoms consistent with severe
  anxiety.
• Diagnosis of HCV causes significant psychological
  distress significantly more stressful than
  divorce, loss of source of income, or relocation
  to another city.

22
Review of the Literature

• Hopwood, M. Treloar, C. The 3D Project
  Diagnosis, Disclosure, Discrimination Living
  with Hepatitis C, Monograph 6, 2003, National
  Centre in HIV Social Research.
• 1/3 participants reported receiving no
  explanation of HCV at diagnosis.
• Only 1/3 reported receiving information
  post-diagnosis.
• Injecting Drug Users less likely to have received
  explanation or information.

23
(No Transcript)
24
(No Transcript)
25
(No Transcript)
26
(No Transcript)
27
(No Transcript)
28
(No Transcript)
29
(No Transcript)
30
(No Transcript)
31
(No Transcript)
32
(No Transcript)
33
(No Transcript)
34
(No Transcript)
35
(No Transcript)
36
Total Sample Hepatitis C Prevalence (n285)
37
Total Sample Hepatitis B Prevalence (n258)
38
Selected Sample Prior Knowledge of Hepatitis C
Status (n58)
Either have never been tested, or did not
receive results. ? Of these, 5 seroconverting ?
Of these, 13 never exposed Of these, 8 never
exposed
39
Selected Sample Hepatitis C Prevalence 1st
2nd Interview (n58)
40
(No Transcript)
41
(No Transcript)
42
(No Transcript)
43
(No Transcript)
44
(No Transcript)
45
(No Transcript)
46
(No Transcript)
47
(No Transcript)
48
(No Transcript)
49
(No Transcript)
50

• Geoff 23 y.o Greg, 25 y.o Anglo males
•         Best mates, moved from Tasmania 9 months
  ago
•         Homeless, living in boarding house
•         Never been HCV tested before
•         Current heroin user
•         Cut down on heroin intake
•         Interested in treatment
•         Geoffs brother had cleared his
  naturally
•         Shared injecting equipment

51
(No Transcript)
52
(No Transcript)
53

• 2. Kate 16 y.o Anglo female
•         Concerned about sexual transmission
•         Did not use protection with sex partner
•         Boyfriend Hep C
•         Current heroin user
•         Shared injecting equipments
•         Previously tested negative
•         Lack of knowledge on Hep B
•         Not in contact with health or welfare
  services
•         Estranged from family
•         Living in hostel
•         New boyfriend, IDU, Hep C

54
(No Transcript)
55
(No Transcript)
56
(No Transcript)
57
(No Transcript)
58

• 3. Minh 21 y.o Vietnamese-Australian male
•  
•         Current heroin user
•         Living in Transitional housing
•         Home is a stop over for friend to have
  hits
•         Seroconverted
•         Friends had shared his needles
•         Was in treatment
•         Not contactable after leaving
  transitional house
•         Missed treatment appointments

59
(No Transcript)
60
(No Transcript)
61
(No Transcript)
62
(No Transcript)
63
(No Transcript)
64

• 4. Amy 19 y.o Vietnamese Australian female
•  
•         Current heroin user lt 5 week
•         Boyfriend, IDU, in jail
•         Loss custody of young daughter
•         Seroconverted
•         Not interested in treatment
•         Wants to check into detox

65
(No Transcript)
66
(No Transcript)
67
(No Transcript)
68
(No Transcript)
69
(No Transcript)
70

• 5. Dora 40 y.o Anglo
•         Health worker
•         Been using heroin 20 years
•         Very informed on BBVs and transmissions
•         Negative at last test
•         Seroconverted

71
(No Transcript)
72
(No Transcript)
73
(No Transcript)
74

• 6. Damien 19 y.o Anglo
•         Negative at last test gt7 months
•         Injecting for 2 years
•         Injects Buprenorphine/Subutex
•         Veins very damaged
•         Shared needles with other Hep C users
•         Injects and shared with mother

75
(No Transcript)
76
Summary

• Reinforce the need for thorough pre post test
  counselling.
• Raise for discussion the need for ongoing support
  information post-diagnosis.
• Raise for discussion the need for innovative
  methods of meaningful education.
• More research on impact of diagnosis
  specifically with IDU groups.

77
Acknowledgements

• Colleagues at Centre For Epidemiology
  Population Health Research.
• Co-investigators at Melbourne University
  Immunology Victorian Infectious Diseases
  Laboratory.
• SHARPS Needle Syringe Program
• Melbourne Inner City Needle Syringe Program
  (MINE)
• Next Door Primary Health Service
• Health Works Needle Syringe Program Primary
  Health Service
• Living Room Primary Health Service
• Turning Point