National survey of HIV and hepatitis testing and vaccination services provided by drug and alcohol agencies in Australia.

Abstract

OBJECTIVES: To identify the prevalence of blood-borne viruses (BBVs) testing, counselling and vaccination services by drug and alcohol services for injecting drug users in Australia. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional survey of drug and alcohol agencies throughout Australia. OUTCOME MEASURES: Current availability of testing, counselling and vaccination services for hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV; availability of medical coverage; and barriers to greater provision of services. RESULTS: Survey responses were provided by 222 agencies nationally (61% response rate). About three-quarters of agencies provided some access to HIV, HBV, and HCV testing and HBV vaccinations, but only a third offered these services routinely on site. HBV vaccination availability differed depending on the primary function of the agency, with drug dependence units and needle and syringe programs more likely to provide vaccination on site. The major barriers preventing agencies from providing routine on-site BBV services are lack of access to medical staff and trained personnel; the cost of providing these services; and a lack of facilities. CONCLUSIONS: The restricted provision of BBV services represents missed opportunities to reduce individual and community morbidity and to maximise the potential savings from preventable disease in relation to HBV infection. To address key barriers and patient retention issues, it is necessary to expand the role of non-medical staff, increase the use of shorter HBV vaccination schedules, and identify and maintain local clinical partnerships between public and private service providers.