Amanda Archer, BS, MPH

Transcription

1 Amanda Archer, BS, MPH

2 The Need Hepatitis C Canton City Stark County From 2010 to 2016, Stark County has seen a 37.4% increase in the total number of newly diagnosed Hepatitis C. Canton City shows a 30% increase. (19% of population with 30% of the cases)

3 The Need Hepatitis C From 2010 to 2015, Stark County has seen a 56% increase in the total number of newly diagnosed Hepatitis C cases across all ages, most likely tied to the opiate and heroin epidemic. Although the Baby Boomers are considered a high risk demographic, from Stark County has seen a significantly larger rate increase of 303% in our year olds since And the year old group is reporting a 118% rate increase since 2010.

4 The Need HIV 10 On average, Stark County sees ~19 newly diagnosed cases of HIV per year. Although intravenous drug use in not currently a leading risk factor in Stark County, the increase in opiate abuse and misuse that the area is experiencing could likely lead to and increase in new HIV diagnoses.

5 The Need HIV: Scott County, Indiana Population: 24,000 (Austin, IN: 4,200) Scott County ranks last among Indiana's 92 counties on several indicators: it has the lowest life expectancy, 9% of the population is unemployed, 19% live below the poverty line, 21% have not finished high school. As of Feb. 1, 2016, 188 people in the area have been diagnosed with HIV in less than 15 months due to injection drug use. A large HCV cluster of some 312 cases overlapped the HIV cluster, with about 25% being co-infected.

6 ORC Bloodborne infectious disease prevention program 9 (A) A board of health may establish a bloodborne infectious disease prevention program (Effective 09/29/2015 (HB 64)) (1) Bloodborne pathogen means HIV, Hepatitis B and Hepatitis C (2) Board of health means the board of health of a city or general health district..(orc )

7 ORC What changed? Before 2015, it was illegal for individuals (not outlined in the ORC) to possess or distribute hypodermics. ORC allows: (F1) Those employed by or volunteering in an established program are not subject to criminal prosecution for the following violations: ORC : Possessing criminal tools ORC : Possessing drug abuse instruments ORC (C1): Illegal use or possession of drug paraphernalia ORC (C and D): Possession or sale of hypodermics: (C) No person other than one of the following shall sell or furnish a hypodermic to another person; (D) No person shall sell or furnish a hypodermic to another whom the person knows or has reasonable cause to believe is not authorized by division (A) of this section to possess a hypodermic.

8 ORC Bloodborne infectious disease prevention program (F2) Those participating in an established program are not subject to criminal prosecution for the following violations, if within 1,000 feet of facility and in possession of documentation: ORC : Possessing criminal tools ORC : Possessing drug abuse instruments ORC (C1): Illegal use or possession of drug paraphernalia

9 ORC Bloodborne infectious disease prevention program (E) Before establishing a program, the board of health shall consult with identified stakeholders: June 22, 2016 SEP Stakeholder Meeting 2015 Stakeholder and Community Online Survey - Determining the Need and Acceptability of a Bloodborne Pathogen Prevention Program in Canton, Ohio Student Research

10 Stark Wide Approach to Prevention Surveyed community and stakeholders about acceptability Created an Ad Hoc Committee from the Opiate Taskforce of Stark County Summer 2016 Met monthly to discuss opportunities and challenges Hosted Stakeholder Information Meeting: June 2016 Several meetings/discussions with local press Identified partners and facilitated discussion Primarily around funding and acceptability

11 Our Program Staffed with Canton City Nurses, HIV coordinator, Epi (and other CCPH staff), Crisis Center Nurse Navigator and volunteers Operate for 2 hours, once a week Held at Canton City Health Department (Downtown Canton) Participants will remain anonymous minimal data collected Facilitate focus groups/surveys several times a year to gain data Each participants receives a Project SWAP enrollment card

12 Participant identification

13 Services include: Access to clean syringes, SWAP Our Program Goal: As comprehensive as possible!! HIV and Hepatitis C rapid testing (and counseling as needed), Distribution of harm reduction kits and education, Distribution and education on Narcan kits, Abscess and wound care education, Treatment referrals for substance use and mental health needs, counseling services Safe sex supplies and education Safe environment

14 SWAP - A Few Successes to Date Support from City Police Chief and department United Way purchased a Needle Shark NS-950 as a disposal solution AIDS Healthcare Foundation Grant awarded (start up funds) Dialogue with community partners is ongoing; not many refusals Crisis Center committed nurse navigator/project DAWN Neighboring LHD agreed to share Hep testing kits Hosted a Harm Reduction Training in March 2017 Received Board of Health Approval March 2017 Held first SWAP clinic on June 23, 2017

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16 Our Program Challenges Funding (currently waiting ) Limited experience with this population/gaining trust Training needs for staff Continued stigma Identifying the needs of the population and what they want

17 Thank You!!! Canton City Health Department 420 Market Ave N Canton, Ohio Diane Thompson, RN, MSN Director of Nursing dthompson@cantonhealth.org Amanda Archer, BS, MPH Epidemiologist II aarcher@cantonhealth.org

18 Sources 1. Drug Policy Alliance 2. Paone D, Clark J, Shi Q, Purchase D, Des Jarlais DC. Syringe exchange in the United States, 1996: A national profile. Am J Public Health 1999 Jan; 89(l): Syringe Exchange in the United States: 1995 Update, HIV Capsule Report, United States Conference of Mayors, February Morbidity and Mortality Weekly Report 2005;54(27): Hagan H, et al. Reduced injection frequency and increased entry and retention in drug treatment associated with needle-exchange participation in Seattle drug injectors. J Subst Abuse Treat 2000; 19(3): National Institutes of Health: Interventions to Prevent HIV Risk Behaviors February 11-13;15(2): CDC: Drug-associated HIV transmission continues in the U.S Phillips, J. Determining the Need and Acceptability of a Bloodborne Pathogen Prevention Program in Canton, Ohio. Unpublished data. Student Master Research. 9. Ohio Revised Code Retrieved from Ohio Disease Reporting System Data 11. Canton Fire Department EMS Data