Active Testing HCV by lindahy

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									   Active Testing HCV
Information campaign and results
   pilotstudy in Rotterdam and
  Dordrecht among drug users

                 Clary van der Veen
                 Trimbos-instituut
                 Trimbos instituut
                 The Netherlands

      Hepatitis C campaign - Bangkok 20-04-2009
Content
C t t
  Introduction
• I t d ti
• Pilotstudy: objectives & design
           y    j              g
• Materials and training
•R        h     h d
  Research methods
• Results
• Conclusion



 Hepatitis C campaign - Bangkok 20-04-2009
Introduction
  Prevalence HCV
• P    l            iti   i the
             HCV-positive in th
  Netherlands
        Opiate d
        O i           ddi   24.000-46.000
               drug addicts 24 000 46 000
        Prevalence HCV + IDU (50-80%)
         12.000-37.000
        Chronic infection (70%)
         8.500-25.000
• Injecting drug users (IDU) largest
  riskgroup HCV


 Hepatitis C campaign - Bangkok 20-04-2009
Introduction
I t d ti
  Under diagnose=>75%; l
• U d di           >75% large group
  unidentified chronically infected HCV
    Potential source of transmission
                    p
    25% will develop cirrhosis
• Knowledge HCV is limited among:
    drug users
    personel of addiction care
    institutions
• Incidental HCV testing

 Hepatitis C campaign - Bangkok 20-04-2009
Pilotstudy: Objectives information campaign


          • Increase knowledge on HCV
             o drug users and personel of
               addiction care institutions (ACI)

            Increase HCV counseling
          • I                       li
             o training personel ACI in
                      li    kill to    ti t drug
               counseling skills t motivate d
               users for testing HCV




            Hepatitis C campaign - Bangkok 20-04-2009
Pilotstudy: Design information campaign

                            01.04.07 31.10.07
          • Period campaign 01 04 07 - 31 10 07

          • Experimental location: Rotterdam
             o 1 addiction care institution: 2 methadon posts
             o 445 drug users
             o Information campaign

          • Control location: Dordrecht
             o 1 addiction care institution: 1 methadon post
             o 250 drug users
             o Care as usual




            Hepatitis C campaign - Bangkok 20-04-2009
Pilotstudy: Design information campaign


                                                       Rotterdam   Dordrecht

           Counseling training                         Yes         Yes
           personel ACI


           Personel ACI offering                       Yes         No
           active HCV
           information &
           counseling
           Information brochure Yes                                Yes
           ‘Rate your state’, ‘Lust
           for Life’
           ‘Russian Roulette’                          Yes         No


           Hepatitis C campaign - Bangkok 20-04-2009
Material and training
   • ‘Russian Roulette’
      o Gameboard, interactive quiz with questions like:
        what is, imagine, what will you do if)
      o Target is increase knowledge and conscience,
        questions lead to conversation about HCV
      o Group and individual
   • Brochure ‘Rate your State’
                 information         HCV symptoms
      o General information, what is HCV, symptoms,
        transmission, what can you do
      o Distribute at all drug users
   • Brochure ‘Lust for Life’
      o Information treatment and experiences drug users
      o Distribute at positive HCV drug users
   • Training counseling skills
      o Increase knowledge HCV, testing and treatment
      o Transtheoretical Model of Change (TMC),
        motivational interviewing (Prochaska & DiClemente)
      o Personel ACI


     Hepatitis C campaign - Bangkok 20-04-2009
Research methods
• Registration addiction care
  institution (during pilot) of:
   o number of counseling
   o number of HCV-tests
• Survey among drug users: baseline
  and postcampaign of:
   o knowlegde, attitude (testing and
     t   t    t)
     treatment)
   o opinion materials
• Survey among personel: baseline
  and postcampaign of:
       o egde/att tude
   o knowlegde/attitude
   o Counseling skills
  Hepatitis C campaign - Bangkok 20-04-2009
Pilotstudy: Results information campaign


         1. Range information campaign
            (counseling and materials)
         2. Effect materials (knowledge and
            attitude)
                    )
         3. Opinion materials (drug users)
         4.
         4 Effect training personel ACI




           Hepatitis C campaign - Bangkok 20-04-2009
Result 1: Range campaign Rotterdam

        • Data registration:
           o   191 counseling interviews
           o   186 tested drug users (97%)
           o   57 drug users are HCV+ (31%)
           o     9 d ug use s a e C        a d ust
               49 drug users are HCV-RNA+ and must be
               treated
        • Materials:
           o Range brochures is unknown
           o 180 participants Russian Roulette
          Counselingtraining:
        • C     li t i i
           o 26 participants (personel ACI)



          Hepatitis C campaign - Bangkok 20-04-2009
Result 1: Dordrecht


         • Data registration:
            o 3 counseling interviews
            o no tested drug users


         • Materials:
            o Range brochures is unknown


         • Counselingtraining:
            o 3 participants (personel ACI)




          Hepatitis C campaign - Bangkok 20-04-2009
Result 2: Effect materials, knowledge and
           attitude
                                               Baseline   Postcampaign
           Rotterdam                           N=125      N=109

           Dordrecht                           N=91       N=85


         • No significant differences in knowledge
           and attitude (baseline and postcampaign;
           Rotterdam and Dordrecht)
         • Drug users have already knowledge and a
           positive attitude to HCV testing and
           treatment
         • Improving knowlegde: transmission HCV
           and treatment


           Hepatitis C campaign - Bangkok 20-04-2009
Result 2: Positive attitude testing and
              treatment
       • Significant connecting factors to testing:
          o    A positive attitude
          o    Concern about health
          o    Knowing the place for testing
          o    Testlocation must be quite near
       • Knowledge about HCV and risk behaviour
         don’t connect with readiness to testing
                             don t
       • By now: drug users don’t request for
         testing of treatment. Therefore active
         counseling and offering test and
         treatment is important



         Hepatitis C campaign - Bangkok 20-04-2009
Result 3: Range materials


          Range with                                  Rotterdam   Dordrecht
                                                      (N=109)     (N=85)
          Rate your state                             N=15; 14%   N=2; 2%

          Lust for life                               N=24; 22%   N=4; 5%

          Russian Roulette                            N=37; 34%   -

          Significant more drug users in Rotterdam
            are known with the materials




          Hepatitis C campaign - Bangkok 20-04-2009
Result 3: Opinion materials

          Rotterdam                    Rate your      Lust for life   Russian
                                       state                          Roulette
          informative                    N=5; 33%      N=12; 50%       N=12; 33%

          understand                     N=8; 53%      N=11; 46%       N=27; 73%
          able
          nice                                   -            -            ;
                                                                       N=31; 84%

          Effect: think                  N=6; 40%     N=6; 25%              -
          about HCV
          Effect: think                  N=4; 27%     N=6; 25%              -
          about own
          behaviour
           • Opinion personel ACI brochures: to much
             information, written text, to many pictures, a lot
             of the brochures where thrown away
           • Ideal combination materials: content/information
             brochures in Russian Roulette format
          Hepatitis C campaign - Bangkok 20-04-2009
Result 4: Effect counseling training

         • Increase knowledge HCV:
            o    What is HCV
            o    How do you catch HCV
            o    How does HCV affect people
            o    Testing HCV
            o    Treatment for HCV

           Increase counseling skills
         • I              li    kill
            o Increase number of counseling (191)
            o Improve attitude motivational
              interviewing



           Hepatitis C campaign - Bangkok 20-04-2009
Conclusions
• Only an intervention targeting
  drug users is not effective
• Personel addiction Care
  Institution are very important:
  offering counseling results in
        g
  testing behavior
• Materials need more range and
  adjustment


 Hepatitis C campaign - Bangkok 20-04-2009
National campaign HCV drug users

       • Start 01.09.2009
       • Participation of 10 Addiction Care
         Institutes
       • Format pilot
          o Training counseling
          o New b    h         d
                 brochures and Russian
            Roulette
          o Offering active information HCV
            and counseling interviews

        Hepatitis C campaign - Bangkok 20-04-2009
      y
Thank you


Hepatitis C campaign - Bangkok 20-04-2009

								
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