A Partnership Approach to Enabling Access to Hepatitis C Treatment Without Visiting The Hospital in a Remote Setting

Author: Anngie Everitt Salamanda Enderman Jaclyn Tate-Baker Melita McKinnon Paula Binks Genevieve Dally Pete Sideaway Jacqui Richmond Catherine Marshall Jane Davies Catherine

Theme: Models of Care Year: 2022

Australian national data from 2016 reports the Northern Territory as having the highest prevalence of
chronic hepatitis C virus (HCV) infection in Australia at 1.54% and the lowest treatment uptake rate.
Therefore, finding, and engaging HCV clients in care is critical. An innovative nurse-peer partnership
(NPP) model of care is being offered in an outreach setting across Greater Darwin region to increase
HCV case finding and engagement in treatment.
An established nurse led monthly outreach clinic has been increased in frequency to a weekly NPP
model of care. With a strong client focus on relationship building, the NPP offers a holistic approach
by offering both clinical and peer support. This is complemented by incentivised screening and
treatment opportunities. The weekly outreach clinic is held within a harm reduction setting, offering
a streamlined one-stop shop for HCV testing and treatment. A case management approach is applied
to individual HCV clients, whilst broader population-wide approaches are used to raise awareness
about HCV.
Over 23 clinics offered, 56 clients have accessed the service, 17/56 (30%) identified as Aboriginal
and/or Torres Strait Islander, 38/56 (68%) were HCV Antibody positive, 13/38 (34%) HCV RNA positive
and 10/13 (77%) have been prescribed treatment. Most report the Needle and Syringe Program (NSP)
as referral source with incentives cited as the primary motivator for people accessing the clinic.
Strengths of the NPP model include the ability to offer a clinical service within a safe, non-judgemental
space, where the complex needs of clients can be met holistically. The mutually respectful relationship
between nurse and peer and reciprocal learning has led to the removal of barriers to care and the
provision of an environment where clients feel valued and safe, ultimately engaging a cohort of clients
who traditionally would not have accessed care in the hospital environment.
Disclosure of interest:
The authors of this work recognise the considerable contribution that industry partners make to
professional and research activities. We also recognise the need for transparency of disclosure of
potential conflicts of interest by acknowledging these relationships in publications and presentations.
The Authors of this work have no conflicts of interest to declare. We also wish to thank the people
living with viral hepatitis that participated in this research.

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