Working with SEPs: How do we expand Hepatitis Services ? Narelle Ellendon, RN HCV Director Harm Reduction Coalition, NYC

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

Awareness…

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