Chair: Eberhard Schatz

In several recent projects and publications, the European Monitoring Centre for Drugs and Drug Addiction and Correlation-European Harm Reduction Network have been promoting effective ways for improving access to the hepatitis care cascade for people who use drugs (PWUD)

The publications  describe different approaches such as the integration of hepatitis testing with harm reduction programmes; strategies of harm reduction programmes to strengthen linkage from testing to care and treatment; decentralized service provision, supported by task-sharing between harm reduction programmes and specialist providers of testing and/or treatment; the integration of hepatitis treatment at harm reduction programmes; and the involvement of peer support workers to reach vulnerable or disadvantaged communities.

• Eberhard Schatz – Harm reduction organisations in HCV testing and treatment. A survey in 33 countries in Europe.
• Dagmar Hedrich – Models of care for drug services in Europe. Case studies and analysis.
• Marie Francis, John Gibbons – Peer supported HCV models of care. Results from the HepCare project.
• Raquel Gloria – Comparison of two proximity-based models of care to increase HCV treatment adherence among people who use drugs in Lisbon.
• Jan Kozak – Harm reduction and integration to care: example Prague.
• F. Oster – Test and treat drug users in a consumption room in the area of DAA’s.

Discussion

Chair: Chase Perfect, Coalition Plus

The parallel session on prisons will focus on key policy barriers and responses to HCV-related services in prisons; it will share knowledge of actions and actors in this space; and it will discuss ways to reinforce networks and advocacy efforts working on this issue.

Criminalization of drug use contributes to high rates of detention and/or incarceration of PWUD. In addition to the high exposure to HCV-associated risks pre- or post-prison of PWUD, the lack of strong public health services in prison can itself further exacerbate those risks. While prisons introduce a broad range of health risks, the correlation of HCV and prison populations is particularly strong; in fact, global estimates suggests that the HCV in prison populations is nearly 5 times more prevalent than TB or HIV.  In most countries, HCV elimination will not be feasible until national responses integrate comprehensive HCV services in prison settings. This includes harm reduction, sensitization, and HCV diagnosis/treatment.

• Rachel Halford (Executive Director of the Hepatitis C Trust) – From pilot intervention to scale up: the mobilization of peer-led approach to engagement in HCV services and the successful effort to push expansion of the model at national level
• Fadi Meroueh:  (Physician CHRU Montpellier, Vice President of Health without Borders) – the challenge of converting prison health systems from obstacle to catalyst of HCV elimination
• Telma Azevedo (Physician at Centro Hospitalar de Setúbal) – Infectious disease consults inside correctional facilities: the experience from a Portuguese Center
• Paschalis Vavelidis (Hellenic Liver Patients Association “Prometheus”) – Access4All : the first holistic intervention for HCV micro-elimination among people in Greek prisons

I  Welcome and introduction – Tonny van Montfort, Rui Coimbra Morais, EuroNPUD

II Abstract  driven session on examples of peer involvement and user advocacy from Norway, Switzerland, France, Slovenia, Greece and the United Kingdom.

III – Integrative moment: Mat Southwell

IV – Small Group questions on Peer Involvement

V – Group debriefing with contributions to a document with a more comprehensive statement on this issue and with the contributions, insights and inputs from the session.

Speakers:

• Ole Jorgen: The Hepatitis Bus – a Norwegian drug user initiative moves on.
• Oliver Werzli – HEPFREE.ch – Peers make the difference to reach out.
• Joachim Levy – Early detection, screening and access to treatment, provided by user groups in Marseille squats and shelters.
• Janko Belin – Campaign Coordination experience.
• Christos Anastasiou  – EuroNPUD country level direct support and the quick development of actions.

Chair: Caren Magen

We will show the effectiveness of the intervention on HIV-HCV risk practices and other complications among PWID and analyze the transferability of this harm reduction tool.

The Eurosider project is a transferability study to implement in 4 European countries an individually-tailored support and education for safer injection (ITSESI) for people who inject drugs. This community-based intervention has already been has shown its effectiveness in reducing HIV-HCV risk practices in France. INSERM (France), AIDES (France), Correlation Network (Hollande) take in charge the coordination. Praksis (Greece), ARAS (Romania), IHF (Bulgaria) and GAT (Portugal) implement the project on the field.

Methods: The project uses mixed methods and implementation science. Itl started with a first exploratory step using quantitative data of each local context chosen for the implementation of the ITSESI intervention and some qualitative interviews with key informers. The second phase  consisted in implementing and evaluating this community-based educational intervention, starting with a training process in the selected contexts. For the evaluation phase, this study  enrolled 300 PWID (75 per harm reduction centre or per country) seeking support for their injection practices and to provide them with the intervention.

Results: From the context assessment, the results showed that financing HR activities for people who inject drugs (PWID), especially the sustainability of Needle Syringes Exchange Program (NSP), has emerged as a determining factor for the feasibility of the implementation of ITSESI as well as the National Drug Policy.

The tools and methods of the training are contributing to guide the next steps with the observation of injection’s practice and the educational session.

Discussion: The results will show the effectiveness of the intervention on HIV-HCV risk practices and other complications among PWID and analyze the transferability of this harm reduction tool. It also demonstrates that ITSESI implementation in different contexts needs to gather material, technical skills and advocacy to ensure a favorable environment.

Chair: Marios Atzemis, Positive Voice, EATG

The session presents challenges and how to overcome them in treating  marginalised groups in different settings

• Joana Correia Pires – The gap between treatment and people living with hepatitis C: a pilot study in a Community Centre in Lisbon.
• Simona Ciobanu – Developed for the community by the community: access to testing and treatment.
• Julian Surey – The HepCare peer intervention project: morbidity, mortality and linkage to care in a homeless population at risk of hepatitis C.
• Zois Zoutsos – ARISTOTELIS HCV-HIV – a holistic intervention for Hepatitis C and HIV infection in people who inject drugs in Athens, Greece.

Chair: Jean Paul Grund, Stop Overdose Now

WORKSHOP

STOP OVERDOSE NOW presents a suite of mobile tools to combat the opioid overdose epidemic that will empower people who use drugs to take action within their own community and when they travel  .

Stop Overdose Now is developing a suite of Ecological Momentary Assessment and Intervention (EMAI) applications that take advantage of the best of mobile technologies to digitally empower the response to the opioid overdose epidemic.

The core application concerns OD Buster, a free community based overdose response networking app that connects naloxone carrying peers and other volunteers with people who use opioids in emergency situations. The app uses modern GPS, inferential positioning, and instant alerting to immediately notify and direct any nearby volunteers to the site of an overdose in progress.

In this workshop we will demonstrate the ODBuster app, discuss its present and future features, and engage the participants in a discussion on the possibilities for deploying it in community based overdose prevention interventions in their work.

Chair: Denis Onyango, African Advocates

The session will highlight and discuss the work of harm reduction and community services for the target group of (un) documented migrants in particular in outreach settings.

• Denis Onyango – The role of community organisations to improve prevention and access to health for migrants
• Moro Yapha – Outreach, peer work and the challenge to prevent infection diseases under undocumented migrants at Görlitzer Park, Berlin
• Elias Phiri – HCV Screening in Migrant Communities in London Borough of Waltham Forest
• Marie Asensio– working with migrants in the streets of Marseille

Chair: Richard Stranz, Aides

Eurosider training Module : Building capacity to support PWID

 After a brief introduction and overview of the content and results of the training work-package, this workshop will allow participants the chance to get a real feel of the content of the training. Trainers from the project will facilitate group work in English to highlight the method of the intervention. Using material from the training, the group work will be based on a case study, observations via video of an injection and identification of empowering, pertinent and key harm reduction messages.

Presentation and group work

The training work package overview and results

Hands on experience/ getting an idea of the training group works based on à case study and video.

• PART ONE: the pre injection interview
• PART TWO Observation of the injection viewing the video
• PART THREE : post injection interview

Conclusions