Hepatitis C Harm Reduction Project

Presentations from the National Viral Hepatitis Prevention Conference

The CDC has posted slides from last week's Viral Hepatitis Prevention Conference.  There were a lot of talks on hepatitis C and injection drug users (IDUs) -- be sure to check out the slides from Thursday's plenary session on hep C prevention for IDUs, particularly the talk by Steve Jones [link to PowerPoint file] that brings together epidemiology, ethnographic observation, and issues for prevention programs.

How Can You Prevent Hep C?

We've launched our hepatitis C social marketing campaign with a series of posters in New York City bus shelters.  The first series of posters focus on prevention -- they're in English and Spanish, scattered around the Bronx, East and Central Harlem, and Brooklyn.

We'll be rolling out related material on hepatitis C prevention in the coming weeks -- for now, here's the text that appears in the bottom of the poster:

Works, sets, rigs, gizmos. Cooker, spoon, cotton, filter, water. Whatever you call them, use them safely when you inject drugs. Hepatitis C is a virus spread through blood that can cause liver disease. So go to a needle exchange or ESAP pharmacy* and take care of yourself and your friends: use a new set each time you inject.

* ESAP pharmacies can sell syringes to drug injectors.  See this post for information about ESAP, and hours & locations of needle exchange programs in New York City.

More poster images available here (including pics with our project's Jen Curry, and the Harm Reduction Coalition's Executive Director Allan Clear).  Right-click on the following links to download larger images of the prevention poster (be patient -- they're big files, in JPEG format):

English and Spanish

Special thanks to our excellent designer, Shawn Torres -- see more of his work here.  Additional thanks to our photographer, Jose A. Arias.

Needle Exchange Programs in NYC

Here's a current list of needle exchange hours and locations in New York City.  We'll do our best to keep this updated, but schedules can change, so it's a good idea to call first.

Many pharmacies also sell syringes over the counter to drug injectors, through New York state's Expanded Syringe Access Demonstration Program (ESAP) -- information about ESAP here, participating pharmacies here.

Follow the link below for needle exchange schedules, organized by borough.

Hepatitis C Blogs

Here's some other hepatitis C weblogs I've come across recently:

Miles Keaton Andrew's Hepatitis C Blog - from a great guy (& a friend) who's been a non-responder to treatment (so far!)

My 'Hepatitis C' Weblog - a blog and treatment journal from Ron Metcalfe in England

Hep C Journal - a treatment diary from Elizabeth Anne in Canada

HCV Treatment Journal - a treatment diary from Sue in Canada

Chronic Hepatitis C - a treatment diary from Debbiejo in Arizona

Heart and Soul: Me 'n' Hep C - a journal from Peter in Vermont, who recently ended treatment

Gathering Wool: Tales of a Black Sheep Living in Post-Christian America

Hepatitis C Outreach Project - from long-time HCV advocate Teresa Hanbey

Hepatitis News - links to news stories about viral hepatitis

I've also been seeing more blogs that aren't hepatitis C-specific, but incorporate the authors' experience with hepatitis C and treatment, mixed in with other aspects of their lives and observations:

"I turned to look but it was gone..." - a New York City graphic artist who just started treatment with Pegasys

Notes from Nina - by Nina Paul, author of Living with Hepatitis C for Dummies

life after interferon - by a blogger living in Israel who achieved a sustained virologic response to treatment last year

Links to many more blogs can be found on these sites:

Peter's Hep C bookmarks

Other Hepatitis C Blogs (from Ron Metcalfe; scroll down and look on the right column)

Hepatitis C Blogs (from Nina Paul)

Not quite a blog, but an interesting new website using wikis with multiple authors:

Hepatitis C Virus Action Now - started by Rudi Cilibrasi, a computer programmer with hepatitis C, who recently wrote about his struggle to obtain medications for treatment on kuro5hin

Are there other hep C blogs you read and recommend?  Add a comment and let me know.

Needle Exchange Stalled in New Jersey

From the Kaiser Daily HIV/AIDS Report:

New Jersey Appeals Court Issues Temporary Injunction Blocking Needle-Exchange Programs in Atlantic City, Camden

The Mercer County, N.J., Superior Court Appellate Division on Thursday issued a temporary injunction to halt the launch of needle-exchange programs in two cities just two weeks before the programs were set to begin, the AP/Long Island Newsday reports. Atlantic City and Camden last year adopted ordinances creating needle-exchange programs and were scheduled to start the projects on July 1 (Delli Santi, AP/Long Island Newsday, 6/20). The cities planned to provide clean syringes for injection drug users in exchange for used ones, as well as referrals to health care providers, social services and addiction treatment programs if drug users asked for them (Livio, Newark Star-Ledger, 6/21). State health officials say the programs would help curb the spread of HIV among injection drug users, who make up more than half of the state's 62,000 people living with HIV/AIDS (Colimore, Philadelphia Inquirer, 6/21). The two cities, along with seven others, were invited by the state to apply for the programs under an executive order signed by former New Jersey Gov. James McGreevey (D) in October 2004. The order declares a "state of emergency" until Dec. 31, authorizes the state health department to administer needle-exchange programs in cities that meet specific requirements and allows up to three cities in the state to establish needle-exchange programs (Kaiser Daily HIV/AIDS Report, 5/20). Appellate Court Judge Stephen Skillman issued the injunction, which was requested by seven state lawmakers who say McGreevey had no authority to sign the order (Newark Star-Ledger, 6/21). The programs now will be postponed pending arguments about their legality (AP/Long Island Newsday, 6/20). An appellate panel will rule on the case after hearing briefs and oral arguments (Philadelphia Inquirer, 6/21).

Stayed tuned, and check for updates from the Drug Policy Alliance's New Jersey office.

Holly Hagan on Hep C and Drug Use

Attached are the slides from Holly Hagan's plenary talk on the epidemiology of hepatitis C and injection drug use in New York, from our recent conference.  Her presentation suggested that we're getting closer to understanding the dynamics of the hepatitis C epidemic among injection drug users (IDUs), and that while prevention will be difficult, it may not be impossible.

Here are some of her conclusions (adapted from her last slide):

HCV is easily transmitted and difficult to prevent -- we can’t apply what we know about HIV prevention to HCV and expect the same results.

However, variation in prevalence and incidence indicates that there are cases where HCV spreads more slowly:

Prevalence between 30 - 90%

Time to HCV seroconversion: 1.5 - 3.5 years from initiating drug injection

This is logical, because not all IDUs are alike and not all injection settings are alike.

We need to study this variation, to understand how we can alter behavior, beliefs and settings to reduce HCV transmission.

For more, see the full set of slides -- and check out the upcoming National Viral Hepatitis Prevention Conference in December, 2005.

Download epi_of_drug_use_and_hcv_in_nyc_hagan_2005.ppt [PowerPoint file]

Hep C in New York Prisons, and other news

The situation in for New York State prisons has improved significantly over the last year: hepatitis C testing is offered to everyone reporting a risk factor when they enter the prison system, with about 13% of men and 23% of women testing positive for hepatitis C antibodies upon entry.  About 300 prisoners are receiving hepatitis C treatment at any time, and prisoners being released to New York City can begin treatment in prison and continue after release through links to city hospitals.  Prisoners with any history of drug use or alcoholism still have to intiate a mandatory substance abuse treatment program in prison before beginning hepatitis C treatment, but do not have to wait until completing the program before starting hepatitis C treatment.  Hepatitis B vaccination is offered to all prisoners.

Prison health care in New York is still far from perfect, as documented by a series of New York Times articles earlier this year that led to an on-going investigation of the state's for-profit contractor, Prison Health Services (see also Business Week's interview with their CEO, Michael Catalano).  But activism and advocacy for prisoners with hepatitis C has clearly begun to pay off.

[More prison news below, plus hepatitis A outbreaks....]

Action Alert - Tell Congress to Increase Hepatitis Funding

From the Hepatitis C Appropriations Partership (HCAP):

The FY2006 House Labor, HHS and Education Appropriation legislation represents an opportunity for Congress to provide critical funding to address the hepatitis C epidemic facing our nation.

The House Labor, HHS and Education Subcommittee is expected to consider the funding legislation on June 9, 2005. Please contact your Member of Congress that sits on the House Committee on Appropriations (list below) and ask them to support a $10 million increase for the Centers for Disease Control and Prevention’s (CDC) Division of Viral Hepatitis (DVH).

More details below.

Drug-Using Communities and Hepatitis C: Conference Round-up

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!

Hepatitis C Conference in Brooklyn

Drug Using Communities and Hepatitis C:
Practice, Research & Policy Conference

A free conference sponsored by the Harm Reduction Coalition!

Join service providers, medical professionals, researchers, drug users and people living with hepatitis C this Thursday, May 26th and Friday, May 27th at:

Marriott Hotel in downtown Brooklyn
333 Adams Street
Brooklyn, NY

For more information and to register, contact Heliana Ramirez at ramirez@harmreduction.org or call (212) 213-6376 ext. 46.

Read on for the full agenda....