Thanks to everyone* who made our conference last week a success -- our speakers, the Harm Reduction Coalition (HRC) staff/interns/volunteers, and especially everyone who turned out and participated. We brought together an unusual range of people from the harm reduction and hepatitis C communities -- everyone from drug users to needle exchange programs to researchers to clinicians -- who brought their passion and commitment, creativity and critical thinking to a rich discussion of the challenges we face in addressing hepatitis C among drug users.
Read on for some session highlights from the conference and follow-up plans on key areas, including social networks and injection cultures.
* Special thanks to the New York City Department of Mental Health and Hygiene, whose support made this event possible, and to the New York City Council for allocating funds to the IDU Health Alliance (IDUHA) which makes our project possible. And extra thanks to Councilmember Christine Quinn for her great opening remarks at the conference!
This Is How We Do It: Injection Culture in New York City
Probably the most well-attended breakout session of the entire conference, speakers and audience members engaged in a fascinating discussion of distinct patterns of drug injection in different communities in New York*. We explored various factors -- race and ethnicity, sex/gender, language and immigration status, and of course drug-of-choice -- that influence how, where, with whom, and why people are injecting drugs, and what that means for hepatitis C (and HIV) risk. The session effectively dismantled the concept of a uniform, monolithic view of drug injection practices, and grew in part out of our meetings with the Hepatitis C Point Person Network -- an informal group of "point persons" within each New York City needle exchange program working on hepatitis C issues in their organizations.
Next step: We're planning on doing a longer follow-up workshop/training session on injection cultures this summer with HRC's Harm Reduction Training Institute -- stay tuned for details, or look for HRTI's next New York City training calendar, which should be posted in June.
* For example, Sarah Lippek from AIDS Center of Queens County talked about injection culture among Russian immigrants -- for some interesting background on injection culture in Russia, see this recent PowerPoint presentation by Yale's Robert Heimer, entitled Homemade Drug Use, Risky Behaviors, and HIV Prevalence in the Russian Federation [PDF file].
Drug Users Speak Out on Hepatitis C
For many, this plenary was the most powerful part of the conference. MC'ed by the inimitable Louis Jones from Positive Health Project (with special guest Annie Bandez), the Speak Out featured current and former drug users (and allies) stepping up to the mike and telling their truths about living with hepatitis C, struggles with medical care and treatment, and coming together for support and activism. We designed this session to put the voices and experiences of drug users at the front and center of how we think and talk about hepatitis C -- hopefully setting a precedent for future hep C conferences.
Next step: Louis, Annie and our project will work on a follow-up get-together/speak out, with a long-term goal of developing supportive environments where drug users can talk about hepatitis C, while linking users interested in taking the next step to hepatitis C organizing, advocacy, and activism. Email me for more information -- and look for future announcements about plans to bring together women artists and activists affected by hepatitis C.
Hepatitis C en Español
This affinity session brought together Latino/a and Spanish-speaking educators, advocates, and needle exchange program staff to talk about identifying and strengthening culturally competent hepatitis C education, support, services, and medical care for Spanish-speaking/Latino injection drug users and needle exchange participants. The discussion explored available (sparse) resources and (substantial) gaps, and strategies to organize more effective and appropriate education and services for Latinos who use drugs.
Next step: HRC will help convene a follow-up meeting with Spanish-speaking needle exchange program staff to push this discussion into action, and help identify and develop better educational resources and training guides in Spanish.
HCV Prevention: Moving Beyond the Individual—Working with Drug User Networks
This informal panel discussion focused on the role of drug user networks in hepatitis C transmission, and explored ways to draw upon the emerging science of social networks* to develop new strategies for prevention and education. Along with myself and Louis Jones, the panel featured Holly Hagan from NDRI's Center for Drug Use and HIV Research -- who also gave a great opening talk on hepatitis C epidemiology at our Thursday morning plenary. Session participants ranged from needle exchange program staff to researchers to drug users and needle exchange participants, leading to a rich, textured discussion with a remarkable degree of consensus on the challenges and opportunities for developing a social network approach to hepatitis C prevention.
Next step: Session participants and panelists were interested in following up this wide-ranging discussion with another meeting to brainstorm ways to put these ideas into practice. We'll be organizing a follow-up meeting in June to keep momentum going and pilot new social network approaches to hepatitis C.
* For some background on social networks, injection drug users, and HIV, see this monograph published in 1995 by the National Institutes of Drug Abuse: Social Networks, Drug Abuse, and HIV Transmission. See also this project description on IDUs' Social Networks and Hepatitis C from Australia's Burnet Institute led by Campell Aitken and colleagues, and a PowerPoint presentation on HIV, drug users, and social networks given in 2003 by NDRI's Samuel Friedman entitled Networks and Interventions.