Since 1998, AIVL has been funded by the Department of Health to provide a national peer-based hepatitis C and other blood borne viruses (BBVs) program of activities targeting people who inject drugs (PWID). Since that time, AIVL has successfully implemented a series of two and one year programs aimed at contributing to the reduction in hepatitis C transmission among people who inject drugs and minimising the personal and social impact of hepatitis C. Much has been achieved in these areas by AIVL over this time.
While AIVL’s initial priority focus had been on hepatitis C, current and emerging issues for people who inject drugs have meant an increasing number of targeted activities relating to HIV/AIDS, hepatitis B and STI prevention, education and treatment have been undertaken. AIVL believes that a program of activities which takes broader health promotion and virus transmission prevention approach will more effectively address issues of BBV & STI prevention, treatment and care among people who inject drugs. We believe that this is the best strategy to meet the interconnected personal and social needs of people who inject drugs, people on pharmacotherapy programs and those living with hepatitis C and/or other BBVs.
The current program of activities is informed by this belief and a strong commitment to the human rights of PWID. Our work takes a peer-based, health promotion approach within an evidence-informed framework.
- Education, Advocacy and Training on Stigma and Discrimination
It has long been recognised that stigma and discrimination directed toward people who inject drugs has a significant negative impact on their health and wellbeing, including their ability to access appropriate testing and treatment for Hepatitis C and other BBVs. Over the last few years AIVL has developed a range of targeted activities to address stigma and discrimination toward people who inject drugs (PWID).
Our work in this area builds upon the findings of a market research report AIVL commissioned in 2009. The final report titled ‘Why Wouldn’t I Discriminate Against All Of Them? – A Report on Stigma and Discrimination Towards the Injecting Drug User Community’ explores the history of stigma and discrimination against injecting drug users in Australia and internationally, it also gives the reader an account of how that stigma and discrimination manifests and its impact on drug users.
In the last two years AIVL has worked on an anti-discrimination public education campaign which produced the well-received and thought provoking film ‘Afternoons with Max Marshall’ and more recently the book ‘Paper Planes’.
The market research findings tell us that the attitudes and concerns of the general public toward people who inject drugs are so entrenched and strongly held that direct confrontation of these beliefs could actually create further barriers to change. More subtle and indirect challenging of these beliefs is therefore required. ‘Afternoons with Max Marhsall’ was therefore developed as a subtle step toward engaging the audience and initiating conversations. ’Conversation starters’ (available on the above website) were developed to assist facilitators in guiding and initiating discussion with groups viewing the film. An external evaluator was engaged to design evaluation components and develop an evaluation report. The short film is suitable for a variety of audiences and has been screened so far with a wide variety of audiences including social work students, drug and alcohol workers and those members of the general public.
‘Paper Planes’ similarly, is a project aimed at the general public to raise awareness of the effects of stigma and discrimination. This project draw upon the finding in the market research that found that women were more likely to challenge stigma and discrimination if given the appropriate information. The short book was successfully launched at the AIDS 2014 conference and is available through AIVL.
AIVL has also produced an anti-discrimination training module for health care workers and students which has seen AIVL provide training across the country. ‘Putting Together the Puzzle: Stigma, Discrimination and Injecting Drug Use’: AIVL Training Module for Health Care Professionals and Students. This training module developed a workshop, which includes training guide, trainers notes, PowerPoint presentation and participant handouts. Targeting health care professionals (such as doctors, pharmacists, dentists and nurses) and students in these fields, the training has been developed so that it can be presented as a half-day or two-hour workshop. The workshop has various teaching activities; group work, role-plays, real-life scenarios and quotes and experiences from people who inject drugs. It is designed to be delivered by AIVL’s member organisations (and by AIVL itself) and trainers are supported by ‘train the trainer’ training which AIVL has been providing to our member organisations and other interested parties over the past two years.
Targeting drug users themselves, AIVL has developed an online resource for reporting of discriminatory practices in health care settings. As part of this visitors to the website can record their experiences of stigma and discrimination in an online survey, get information about their rights and how to make complaints and get further information. AIVL has also developed a short you tube video ‘Know Your Rights’ aimed at drug users directing them to the online survey and highlighting the issue of discrimination against drug users in healthcare settings. The video will be released on International Drug Users Day November 1st 2014. In the meantime AIVL is busy collating the findings of the survey. Preliminary results indicate and overwhelming number of drug users are experiencing discrimination on a regular basis and this is having devastating effects on their lives.
- BBV Prevention and Peer Education
The National Peer Education Project aims to provide a national training program for IDU peer educators to build skills and capacity and to improve the quality and consistency of hepatitis C peer education and support amongst people who inject illicit drugs and/or are on pharmacotherapies. One aspect of this has been the delivery of workshops to with peer educators utilising a range of delivery methods and associated course materials.
Each year the project conducts workshops with follow up activities where appropriate. Workshops are adapted to meet the needs and issues for IDU. In addition to this an online Peer Education site has been developed by AIVL to support the on-going training, development and information needs of IDU peer educators. The site is a ‘members only’ environment that offers a range of resources appropriate to supporting the needs of IDU peer educators.
AIVL is also currently conducting a ground breaking study into the re-use of injecting equipment in Australia. The Re-use of Injecting Equipment Research Project is a two year project in its final stages based upon the analysis of qualitative data collected across Australia in focus groups facilitated by AIVL staff. Drawing upon the guidance of an expert advisory committee the research aims to examine the complex reasons behind the re-use of injecting equipment among injecting drug users by speaking to drug users themselves. Re-use of injecting equipment is the leading contributor to new Hepatitis C infections in Australia. This is the first study of its kind using a peer led research model to explore the reasons behind on-going re-use of equipment. AIVL will present preliminary findings at the up-coming APSAD conference in November 2014 with the final report available in early 2015.
AIVL has been in the process of updating our website and as part of this a new, revised and updated 24 Hour Online NSP Listing will be launched at the Australasian Viral Hepatitis Conference to be held in Alice Springs in September 2014. The new listing is compatible with smart phones and other hand held devices and is a fully searchable listing for Australian NSP services including maps and directions. To coincide with the new website AIVL will also release its new updated Legal Guide for drug users.
- Information and Support on HCV Testing, Diagnosis and Treatment
AIVL maintains up-to-date information via our website on issues for drug users related to Hepatitis C diagnosis and testing. We have also been involved in key events through the year such as World Hepatitis Awareness Day 2014 where we ran a webinar on the topic of ‘treatment as prevention’ and AIDS 2014. AIVL maintains a strong presence at the Australasian Viral Hepatitis Conference and will be involved in chairing sessions and running a National drug user organisations booth in the next conference in September 2014 in Alice Springs.