Harm Reduction Victoria

We want to give Hep C a lethal Injection!

by loki on 01/03/2016


Always use sterile equipmentWhen it comes down to it, blood borne viruses are the main drivers of Harm Reduction Victoria.  Hep C most of all.

Hep C first emerged in the late 80s, right on the tail of the AIDS epidemic. And, for a while there, it looked like it was a comparable disease and a comparable death sentence.

But in time, due to the work of the medical establishment and the same harm reduction strategies that saved people who inject drugs from HIV/AIDS, hep C lost its lethal aura. And as the fear dissipated, so did our precautions.

A sense of normalcy and even complacency set in – since everyone has got it.

I mean, what’s the worry? Most of us don’t have symptoms or severe ones. It’s easy to forget you’ve got it and just get on with your life. After all, people are living with it not dying from it.

Well, we @ HRV are here to remind you that hep C is still alive and well. And spreading. . . . . . .

It is threaded right throughout our community, the community of people who inject drugs. It has overwhelmed our community in many, many ways – and the longer term prognosis of chronic hep C means its impact will only increase, as we all get older.

The virus still negatively impacts people’s lives, in a million and one ways and it is still deadly. Our harm reduction efforts are too often failing to hit the mark, as 80% of current infections and 90% of new infections are due to injecting drug use. The virus continues to circulate freely in our community. It is a major epidemic which almost exclusively affects us, i.e. people who inject drugs.

This part of our website is called ‘Blood borne viruses’ but it is not about facts and figures. (We’ve provided links to sites bursting at the seams with that sort of generic information.) What we want to talk about here is attitude and behaviour. We want this part of HRV’s website to be a call to arms!

We are the infected and the potentially infected. When it comes to hep C, we are the affected community. Because this virus has infiltrated no other section of society, we are the only ones who can stop it in its tracks. We need to own this virus. And we have the means to put it down.

HRV is on a war-footing. We want to mobilise the injecting drug using community against hep C – and, miraculously, the actions required for us to succeed are dead simple. (You may not even have to get off the couch.)

At its most basic, all we need is a small mental shift coupled with a shift in behaviour – and everyone has a part to play.
Those of us who already have the virus, we are the gatekeepers.

Dont Share a Bloody Thing! Our job is to contain its spread. Our blood is the viral reservoir and our duty is to keep it quarantined by never sharing any of our injecting paraphernalia and always safely disposing of fits. (Also, be aware of the minuscule chance that razors and toothbrushes may be a source of household infection.) If you inject in the company of others – especially if they don’t have the virus – do not pass up the opportunity to educate and to demonstrate safer practices. Even the act of initiating someone to injecting – as reluctant as most of us are to be involved in such a step – is an opportunity for education. (And research indicates that the way we were first taught – or not taught – to inject colours our injecting practices from then on.)

For those of us living with the virus, there are ways to take care of ourselves despite the toll the virus takes over a lifetime.

Overall, opioid injectors are ageing and some of us will be hitting the 20 or 30 year mark of living with hep C. And that’s the point or the problem. It is in the longer term and due to the accumulative effect of living with chronic hep C, over many years that the damage is done to the liver. Some of us will start to experience more severe symptoms, including fibrosis, cirrhosis and cancer.

A small number of us will die.

The good news is that most of us will die with hep C not from it.

Although only a small minority (approx. 5%) will die from hep C related causes, the trouble is there is no way of knowing whether you will be one of the lucky ones or not. Ironically, perhaps, (given the strong association between injecting drug use and hepatitis C) reducing our alcohol intake is the best thing we can do for our livers. Binge drinking in particular is especially harmful for the liver.

Finally, it’s worth thinking about treatment. Although we are the group most affected by hepatitis C, far too few people who inject drugs are taking this step.

We at HRV believe that everyone should have the option of treatment.

Treatment will not be everyone’s choice and not everyone will clear the virus with treatment, unfortunately. However, in the last few years, more effective drugs have become available, increasing the odds of clearing the virus and others are on the horizon. There is no better time to stop your liver becoming a rice pudding.

Harm Reduction Victoria is planning to develop several new programs for people who inject drugs who are living with 
the virus. The new programs are:

  • ‘Living with hepatitis C’  to assist you to live well with the virus
  • ‘The Treatment Journey’ to assist you to identify and navigate the barriers to antiviral treatment.

Watch this space!

Those of us who have managed to avoid infection, we are the front line of defense. We must learn how to protect ourselves.

Hep C is invisible to the naked eyeHow?

  • By having our own injecting equipment.
  • By asking questions.
  • By educating ourselves and our mates.
  • By staying informed.
  • By being prepared to stick up for ourselves and demanding a clean fit.
  • By not always taking what we get and thinking it’s good enough.

It only takes one rash move – if it involves using someone elses fit – to get hep C. And once you’ve got it, for most of us, it’s for life.

The changes we’re talking about will not come about if individual drug users do not have support at a collective and community level. We at Harm Reduction Victoria want to use our unique position to galvanise such support. We want to transform users’ social networks into conduits of information and clean equipment. We want to work with key people within friendship networks and support them to provide peer education and to model safer drug use as well as to distribute sterile injecting equipment to their friends and associates. We want to target specific groups who are not well served by existing NSPs, including people who inject drugs, who are younger, aboriginal, from CALD backgrounds, etc.

We want to mobilise the entire injecting population to stop this virus in its tracks!

Hep C is microscopicWe did it with HIV/AIDS. Australia’s response to HIV demonstrated the strength of a partnership approach which involved multiple players including  government, clinicians, researchers, healthcare workers, etc., etc. as well as the affected communities. However, ultimately, the anticipated HIV epidemic among injecting drug users never happened in this country because people who injected drugs educated themselves and each other and changed their drug using 
practices. If we did it with HIV, why can’t we do it with hep C?

We are particularly excited about our plans for a Peer Distribution Program. Despite our excellent NSPs, they are not open 24/7 (or 31!) and there will always be gaps in coverage: inevitably, there will always be users who find themselves without a clean fit at just the wrong moment. This problem could be – and very often is – solved by peer-to-peer distribution of equipment, despite the fact that it is technically illegal.

As an adjunct to the existing NSP network, HRV plans to recruit, train and support suitable candidates to distribute clean fits – and accurate information – within their social groups. Happily, we have found a loophole in the law which enables us to do this legally and without jeopardising anyone’s safety.

In addition to these on-the-ground activities, we plan to lobby for a change in legislation in order to address the current (unhelpful) legal status of peer distribution so that we can all become de facto needle & syringe distributors all the time without breaking the law.

We’ll keep you informed and updated about the peer distribution program as we roll it out at different sites over the coming months. We’d love to hear your ideas and feedback about how we can make this work.  It’s time to take hep C seriously again, but only you – yes, you! – can halt its relentless progress. Harm Reduction Victoria is here to give you all the support you need, and together we might just be able to chop it into little bits, throw it in a dumpster, douse it in petrol, burn it to ashes – and stop it in its tracks, once and for all.

See you on the ramparts!

AIVL our peak body are thinking along the same lines.

one drop of blood can change your lifeThere is no blame, no shame; hepatitis C is a reality for people who inject drugs and while drug use remains illegal it will be virtually impossible to eradicate hep C completely. But as a community we can do so much better for ourselves and our friends. Always make sure we have more than enough injecting equipment, encourage people to slow down, take their time and inject safely. Support each other to get tested; go with each other or babysit each other’s kids.

Let’s beat this virus and make it two out of two, after all we beat HIV as a community.’

For information about hepatitis C :
What is hepatitis C?


AIVL’s Hep C Society – News, Research & Developments

  •        Looking After Our Health with Hep C
  •        Thinking About Treatment
  •        On Treatment
  •       After Treatment
  •       The Dope on Hep C

Research, News & Developments

Further reading:

All images on this page created by Stonetree.

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