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January 2014 |
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consent form – we won’t
do anything without that,
because we’re doing
things with people, and
any time anyone wants to
pull out, that’s fine.’
Since the service
launched, however,
awareness raising and
sharing information has
come to be as important
as the testing itself, he
explains. ‘I wouldn’t
say hep C’s complex,
but people can still be
unclear, plus a lot of
what we’re doing is
just helping to
destigmatise it. People
see the van with
“Hepatitis C Trust” on
the side in huge letters,
and it’s, “some people
have got hep C, get
over it”. It’s helping to
debunk some myths as
well. It’s a blood-borne
virus that’s difficult to
catch unless you’re doing
things that involve your
skin being pierced. I
remember saying I had hep
C and it was, “Well, you’d
better have your own cup
now” and all the rest of it,
but rehabs used to be like
that. But the fact that I’ve had
hep C and was using drugs until
about 20 years ago is really
helpful because it means I can
communicate with people.’
The Department of Health
funding is due to run out in April,
however. What happens then?
‘Black hole scenario,’ he says.
‘But it is a front-line service so
hopefully we’ll be able to find
some funding sources. What
we’d really like, rather than us
doing this, is to get the local
authorities to do it, because it
makes economic sense and hep
C is a public health issue. At the
moment everything’s in a state
of flux but it would be crazy to
not fund an essential service,
so we’ll just have to find a
different way to do it.’
A lot of services do offer
testing themselves though. ‘They
might offer it, but do they actually do
it?’ he says. ‘There’s world of
difference. “Do you want a test? No,
alright then” – then they’ve offered
someone a test. BBV provision has
been going downhill because it’s
expensive and it’s a marginalised
group. You’re even seeing contracts
pulled from the mobile needle
exchange services now – really
successful services working with the
street homeless. So if you’re not
getting funding
for services like
that you do worry
about hep C
testing because
there’s no
immediate
impact, whereas
take away the
needle exchange
vans and
straightaway
you’ve got
needles in the
parks and so on.’
One thing that
could ‘massively
improve’ matters
would be a
greater focus on
peer support, he
stresses. ‘There
seems to be a
large hidden
cohort of people
who’ve been
tested but then
nothing happens.
I hope that’s what we’re going to
target next and we’re involved in a
research project to try to get some
evidence that people who have peer
support get better outcomes. It does
seem to be catching on that if you
train the peers up they can support
people to go and get the
appointments for blood tests and
follow-ups, and maybe get a support
group in place.’
He’s adamant that this shouldn’t be
staff-led, however. ‘That’s why we’re
having this big push to try to get
peers trained up so they do know
what they’re talking about. People
who have experience of drug use and
having the virus are really helpful,
because they’re listened to. A staff
member in a rehab or drug service
doing a talk – together with every
other thing they’ve got to deal with
and get across – isn’t going to get the
information out so that people take it
in. Peer intervention is key.’
Another crucial aspect is that if
people ‘face up to their BBV status
then they’ll maybe face up to their
recovery status,’ he says. ‘One of the
things that we’ve really noticed is
most people who use drugs think they
have hep C. But a lot of people
haven’t got it, so we’ll say “why are
you doing stuff to put yourself at
risk?” No one wants to walk around
paranoid thinking you’ve got a chronic
illness when you haven’t, and you get
all sorts of scare stories as well. So
it’s about getting the truth out.’
To arrange a visit email
Jim.Conneely@hepctrust.org.uk