Wednesday 12 June
Integrating treatment: the opiate substitution therapy clinic in the evolution of hepatitis C treatment
Mr Jake Rance is a Research Associate at NCHSR
Location: Room 221, Level 2, John Goodsell Building.
Map reference F20.
The hepatitis C (HCV) epidemic is a significant public health challenge. With over 1% of the Australian population infected, hepatitis C-related mortality now surpasses HIV/AIDS. Nonetheless, treatment uptake remains low and innovative models of care are required. Worldwide, there is growing interest in the provision of care and treatment for HCV infection beyond the specialised clinics of tertiary hospitals. In Australia, such efforts are focussed on the opiate substitution therapy (OST) setting where HCV prevalence among the service-user population is
The Australian ETHOS (Enhancing Treatment for Hepatitis C in Opiate Substitution Settings) Study was established to examine the feasibility of introducing HCV care and treatment into OST clinics. This seminar draws principally on findings from an NCHSR-lead, qualitative sub-study of this larger ETHOS initiative: an evaluation of service-user and provider experiences of the integrated treatment model piloted across four NSW OST sites.
Tracing the evolution of our thinking around the new treatment model, this seminar will begin with a synopsis of our earlier work, which explored the question of organisational power and culture operating within OST and the ‘socio-spatial stigmatisation’ of the service user. Our current work will then be introduced, noting that despite the stigmatisation frequently embedded in the everyday institutional practices of OST there are transformative possibilities emerging as a consequence of the integrated model of care. Perhaps the most
remarkable, if unanticipated, data emerging from the pilot sites concerns this theme of transformation: the realisation of alternative, ‘non-addict’ identities from within a clinical setting where the stigmatising figure of ‘the drug user’ has traditionally prevailed.
Jake works with the viral hepatitis team at the National Centre in HIV Social Research (NCHSR). He joined NCHSR following nearly a decade working in harm-reduction services in Sydney’s Kings Cross, including a number of years as the Counselling Unit Manager of the Sydney Medically Supervised Injecting Centre. Jake’s seminar draws on his recent work at NCHSR exploring the relationship between the spaces, subjects and cultures of opiate substitution clinics, and the critical implications this holds for the proposed introduction of hepatitis
C treatment into such settings.