Introduction

This training manual has been developed to improve the treatment and care of people who inject drugs (PWID) and who are affected by Hepatitis C (HCV).

It has been written for people who are responsible for delivering HCV treatment and care with PWID, including those working in harm reduction, drug treatment or other health and social care services. PWID who fulfil an advocacy role are – themselves – also a vital audience for this resource.

The manual is structured around a three day learning programme with modules that: introduce HCV, its transmission and prevention; examine the diagnostic tests and treatments that are used and the evidence that underpins these; consider the issues that arise in the case of co-infection with HIV; and, promote reflection on some of the key organisational, practice and policy issues that affect the provision of HCV treatment and care.

Although there is an underlying three-day structure, the programme is modular and intended to be used and adapted in line with people’s needs, their local situation and the opportunities and resources available.

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Background

Hepatitis C is both widespread and can cause life-threatening problems. It has been estimated that 3% of the world’s population (170 million people), have been infected). Complications include cirrhosis, hepatocellular carcinoma (HCC) and liver failure (World Health Organisation 2010). Across Europe, People who inject drugs are by far the largest group affected by HCV with prevalence rates that can exceed 80% (EMCDDA 2010).

Experiences vary from country to country but factors such as stigma, discrimination, criminalisation, imprisonment and state oppression all have an immense effect on HCV treatment and care. This makes it important to consider the needs of people who inject specifically, because these can differ significantly from those of the general population.

Medically, the development of effective treatments now means that for many people HCV can, in effect, be ‘cured’. The timely provision of effective treatment can also prevent the spread of infection, contribute to curtailing the epidemic and protect others. Simply put, someone who is no longer infected with HCV cannot pass it on.

However, as important as halting the HCV pandemic undeniably is, the main reason for being concerned to improve HCV treatment and care is because PWID are citizens and members of our society; not separate from it. They are our mothers, fathers, daughters, sons, sisters, brothers and, as such, have the same entitlement to high quality treatment and care as anyone else.

This training manual aims to develop learners’ understanding of best practice in HCV treatment and care for PWID. This knowledge underpins the development of people’s skills and their capacity to shape the provision of effective supports, systems and services that combine to reduce the impact of HCV.

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