ID: 533

Type of submission: Oral

Conference track: Research

Topics: Needle and Syringe Programmes; Viral Hepatitis and Tuberculosis

Presenting author: Jenny Iversen

Presenting author biography:

Jenny has worked in the harm reduction sector since the early 1990s, previously as a health service manager and health policy analyst. She currently oversees the coordination of surveillance projects within the Viral Hepatitis Epidemiology and Prevention Program at the Kirby Institute UNSW and holds an NHMRC Early Career Fellowship.

Syringe coverage and prevention outcomes in regional/remote Australia

Jenny Iversen, Amy Kwon, Lisa Maher

Background: Needle and syringe programs (NSPs) are an essential component of the World Health Organisation’s comprehensive package of interventions to prevent transmission of HIV and hepatitis C virus (HCV). The recent outbreak of HIV among people who inject drugs (PWID) in rural Indiana in the US highlights the need for NSPs to be accessible beyond major urban centres. This study investigated the geographic accessibility of NSPs, syringe coverage and notifications of HCV in regional/remote Australia.

Methods: The Australian Standard Geographical Standard was used to collate measures of NSP geographic accessibility, syringe coverage and new diagnoses of hepatitis C infection to the National Notifiable Diseases Surveillance System (NNDSS) in 2015.

Results: In 2015, 46 million syringes were distributed in Australia, with an estimated 15 million syringes (33%) distributed in regional/remote areas. Per capita syringe distribution was higher in regional/remote areas than in major cities (2.4 vs 1.8). Three quarters (74%) of Australia’s 1,232 public sector and almost half (46%) of the 2,318 pharmacy NSPs were located in regional/remote areas. Of the 10,593 new diagnoses of HCV in 2015, one third (n=3,799, 36%) of cases resided in regional/remote areas. The HCV notification rate per 100,000 population was 59 in regional/remote Australia compared to 40 per 100,000 in major cities.

Conclusion: Australia has a large network of government, community and pharmacy NSPs that provide extensive geographic access in regional/remote locations, with per capita syringe distribution higher than in major cities. Despite these promising indicators, the rate of new HCV diagnoses was 50% higher in regional/remote areas than in major cities in 2015. Relatively few (n=42, 2%) NSPs in regional/remote locations have staff with specialist knowledge of injection drug use. Our findings suggest that provision of syringes in the absence of health education/information may be insufficient to prevent transmission of blood borne viral infections.