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Working with SEPs: How do we expand Hepatitis Services ?. Narelle Ellendon, RN HCV Director Harm Reduction Coalition, NYC ellendon@harmreduction.org www.harmreduction.org. Why work with SEPs?. Prevent the spread of any blood-borne infections, including HIV and Hep C
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Working with SEPs: How do we expand Hepatitis Services? Narelle Ellendon, RN HCV Director Harm Reduction Coalition, NYC ellendon@harmreduction.org www.harmreduction.org
Why work with SEPs? • Prevent the spread of any blood-borne infections, including HIV and Hep C • Make and maintain contact with active injectors outside of the health care system • Varied delivery, size, nature, populations, etc, etc, etc…
Why SEPs ??? • It’s not just the Syringes, it’s not just the SEP. • Bridge to treatment and other services - HIV testing & counseling - Medical & Mental health services - Case Management - Housing - Food programs - Support groups
SEP Participants • Many IDUs not using SEPs • More then half acquire syringes from potential unsterile source • Nearly half report “sharing” syringes and other equipment • Generally participants of SEPs have been injecting for some time • Large number of IDUs already infected with HCV
HCV Prevention Attitudes • HCV infection is INEVITABLE • HCV infection is INCONSEQUENTIAL • HCV infection is INDETERMINATE
Limitations of SEPs to address HCV? • Lack of expertise & training • Competing Priorities • Lack of referral options for DU’s • Funding Limitations • Regulations on syringe provision • Police Harassment • Federal ban
Where to begin…… • Assessment: - Participant - Staff - Program Evaluation not just for Data. Process of assessment needs to provide Education & Interventions.
Adding Hep C….One size does NOT fit all… • Tailoring Program Strategic Plan to the SEP. • HCV Networking, (Motivation & Position) • Tailored Training, (SEP Staff, Other services) • Peer Education • Manuals & Curriculum • Materials
Adding Hep C…. • Build on existing assessment tools • HCV Screening & Hep A/B Vaccs services • Linkages to care & treatment
Advocacy • Local & National forums to bring the focus on Hepatitis C & Drug • Coaching/Mentoring internal program advocacy • Community focus, African Americans & HCV • Pharmaceutical companies • Funding
IDUs more likely to not be infected with HIV or HCV if….. • Avoid situations that threaten safe injection: - withdrawal period - lack of syringes - high-risk contexts - institutionalization • Match equipment supply with drug supply • Maintain connection with community
Opportunities…. • Validate & Share IDUs strategies to avoid HCV Infection. • Change syringe quotas • Tap into Social Networks, Peer Secondary Exchange • Police/Community Education • Address stigma of Drug Users using other services • Federal Ban on $ for SEP • Safer Injecting Facilities