Injecting Drug Use
Exploring the similiarities and differences of hepatitis C treatment and opiate substitution treatment therapy in people who inject drugs to inform increasing access HCV treatment in this population
Supervisors: Prof Margaret Hellard, Dr Peter Higgs
Project Site: Burnet Institute
Contact: E: peterh@burnet.edu.au; E: margaret.hellard@burnet.edu.au
Project description: Pharmacotherapy, when used with regard to substance dependence refers to the replacement of a person’s drug of choice with a legally prescribed and dispensed substitute. Known as opioid substation therapy (OST) in Victoria over 14,000 people are currently being dosed daily with methadone or suboxone for their heroin dependency.
Currently few PWID receive treatment but the advent of new direct-acting antiviral (DAA) treatment provides opportunity for increased uptake of therapy which will have the duel benefit of curing the PWIDs HCV and also potentially reducing HCV transmission (through treatment as prevention (TasP)) leading to HCV elimination in Australia.
Working with participants from the Treatment and Prevention (TAP) Study, a world first study of community based treatment for PWID and HCV elimination, this honours project will explore the PWIDs attitudes and understandings of the new DAA HCV treatment, the best mechanism to provide DAAs to the – separate to or with OST. The overall aim is to identify mechanism to increase PWIDs access to DAAs and compliance with DAA treatment so as to inform HCV elimination in Australia and globally.
The study will use qualitative methods including in-depth semi-structured interviews to achieve the research aims. An interview guide will be developed to map broad areas of investigation and to lead the semi-structured interview process, which will be inductive to allow for the generation of new ideas and knowledge that may otherwise remain uncovered.
The outcomes of transitioning between prison and community for people with a history of injecting drug use
Supervisors: Prof Paul Dietze, A Prof Mark Stoove
Project Site: Burnet Institute
Contact: Paul Dietze E: paul.dietze@burnet.edu.au
Project description: Injecting drug use contributes disproportionately to the health and social burden of illicit drug use in Australia. Sustained patterns of problematic injecting drug use are influenced by a complex interaction of social, health, structural, and policy factors, including the ongoing criminalisation of drug use and the routine incarceration of people for drug-related crime.
People who inject drugs (PWID) are vastly over-represented in the prison and broader criminal justice system. Transition out of prison represents a particularly vulnerable period for PWID that is characterised by challenges associated with social reintegration, housing, employment, accessing health and other support services, and relationships with significant others. Return to dependent patterns of drug use following prison release is also common, resulting in very high rates or mortality, morbidity, recidivism and re-incarceration in this population.
Burnet Institute is undertaking Australia’s first prison-to-community prospective cohort study of people with injecting drug histories. This study provides an opportunity for analysis pre- and post-release data collected from 500 participants in the weeks preceding prison release and in the first three months following their release. A range of post-release outcomes are available for investigation, including but not restricted to patterns of drug use, engagement and retention in treatment and health care, overdose, housing stability and blood borne virus risk. Univariate descriptive and prospective analyses examining the pre- and post-release predictors of outcomes will be undertaken to help inform policy and practice in the Justice and Health arenas.
The persistence of risk among people who inject drugs - also offered as MBiomedSc
Supervisor: Professor Paul Dietze, Co-Head , Alcohol & Other Drug Research, Centre for Population Health,
Project Site: Burnet Institute
Email: Paul Dietze E: paul.dietze@burnet.edu.au
Project Description: The prevalence of risk behaviours such as sharing of injecting equipment among people who inject drugs (PWID) has been well described in the Australian context. However, little is known about transitions in risk behaviours among PWID over time and whether Australian PWID moderate their behaviours in response to their changing circumstances. In this study data from the Melbourne Injecting Drug User Cohort Study (MIX) will be examined to determine the extent to which risk behaviours change over time in the cohort and what impact any changes have on key health outcomes such as blood borne virus transmission.