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National Drug Alcohol
Research Centre
Resource Type:
TR.262.pdf

NDARC Technical Report No. 262 (2007)

EXECUTIVE SUMMARY

Most Australians who have hepatitis C contracted the virus through the shared use of drug injecting equipment. Further, the prevalence and incidence of hepatitis C virus (HCV) are high among Australian injecting drug users (IDUs), around 50 to 60 percent and 15 percent respectively. The task, therefore, of controlling the spread of hepatitis C depends largely on controlling transmission among IDUs. Although there is a considerable body of research describing hepatitis C epidemiology and infection risk factors, very little research has examined IDUs’ understanding of hepatitis C. The aim of the current study, therefore, was to examine IDUs’ knowledge of hepatitis C, their understanding of virus transmission, the clinical markers and symptoms of the virus, and treatment in particular. How IDUs prioritise hepatitis C relative to other life areas was also examined.

A cross-sectional survey, using an interviewer administered, structured questionnaire, was conducted across inner-city, suburban and regional sites of New South Wales. Participants were recruited through advertisements at needle and syringe programs (NSPs), methadone clinics, and snowballing (word-of-mouth) techniques. Participation was not determined by hepatitis C status.

One hundred and forty nine IDUs were interviewed. The median age of the sample was 34 years and approximately two-thirds were male. The median age of first drug injection was 17 years, with the most commonly reported illicit drugs injected in the last month being amphetamine (62%) and heroin (61%). Over half of the sample (62%) was in treatment for drug use at the time of interview, with the majority in a methadone or buprenorphine program. Over half the sample rated their knowledge and understanding of hepatitis C as either ‘good’ (30%) or ‘very good’ (23%).

Testing for hepatitis C was common among the sample, with all but one participant tested for hepatitis C in their lifetime, and the majority (74%) tested one or more times in the past 12 months. ‘Routine screening’ was the main reason selected for their last test (39%), followed by ‘mandatory testing’ (13%) and then ‘risky behaviour’ (12%). Seventy six percent of the sample believed they had hepatitis C at the time of interview. Despite most participants reporting recent and often multiple testing, a number of IDUs were clearly confused about the results of the various tests. Only about 40 percent of those tested during or after 2000 reported receiving pre- and post-test counselling.

Significant gaps in IDUs’ knowledge of hepatitis C were uncovered in the study, with respect to transmission risks, symptoms, clinical markers and treatment. For instance, substantial proportions of participants believed it was possible to contract hepatitis C by re-using their own needle (48%), or from dirt (17%). Forty-two percent of participants believed antibodies to hepatitis C gave protection against acquiring the virus (42%), and over one-third (35%) believed that some people are immune to hepatitis C. IDUs’ understanding of their own hepatitis C infection was similarly confused, with one in five participants who reported having hepatitis C believing they could not infect others (19%), and that they were immune to hepatitis C (19%). One in three participants stated they did not have antibodies for hepatitis C, and an even greater number were unsure, despite reporting themselves to have hepatitis C.

Very few IDUs were found to prioritise hepatitis C highly relative to other life areas. For many IDUs, hepatitis C appears to be a relatively low priority compared with the numerous health, welfare and social concerns that exist among this often economically and socially marginalised group. However, health was frequently selected as one of the most important life areas determining quality of life, which may incorporate symptoms and sequelae resulting from hepatitis C impacting on day-to-day life.

Given the high prevalence and incidence of hepatitis C among Australian IDUs, and that many continue to share injecting equipment, the findings of this study are of great concern. The fundamental misconceptions held about hepatitis C, particularly regarding ‘antibodies’ and their perceived role in providing immunity, place IDUs at serious risk of transmitting and contracting hepatitis C. These findings warrant further development of, and research into, strategies to improve IDUs’ understanding of hepatitis C.

Citation: O'Brien, S., Day, C. Black, E., Thetford, C. and Dolan, K. (2007) Sydney: National Drug and Alcohol Research Centre.

Popular Resources

Museum ofApplied Arts Sciences
Observations

By The Museum of Applied Arts Sciences

June 8, 2011

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An ejected prominence on the Sun on 21 May 2011. Image and copyright Harry Roberts ©, all rights reserved plus the DailyShoes Womens LaceUp Ankle Padded Collar Work Combat Hard Toe Booties Dark Brown Grey Navy Black Pu 7PeuVBZqw
for last panel

Most solar filaments end their lives by ejecting into space, and when this happens at the solar limb, H-alpha users see an impressive event – often termed an “eruptive prominence”. Terrestrial observatories seldom record such events, as they do not monitor prominences continuously, though with luck the satellite may get an image.

Most filaments erupt while on the bright disc (rather than the limb) where they are harder to see. In most filters they abruptly vanish (termed “disparition brusque”) because the filament’s ejection velocity causes a Doppler blue shift that exceeds the filter’s pass bandwidth. For instance a 0.7Å filter will be ”blind” to a filament ejecting at approach velocity >35 km/sec – a “low velocity” where the sun is concerned. By contrast, an ejection at the limb is not Doppler shifted, as the ejecta has almost no approach velocity.

2011 May 21st was clear and hazy with very good “seeing”. Many solar features were visible on the disc; spots, filaments etc, and at the SE limb a large faint “hedgerow” prominence. Timings showed the feature stretched around the limb from 36ºS to 52ºS (~200Mm length) and was about 37Mm (37,000km) high. These latitudes were higher than those of current sunspots, and showed that the filament (prominence) was a so-called quiet region filament (QRF) formed by weaker (~10 gauss) solar surface fields – and was not associated with any current sunspots, where fields are ~ 2000 gauss.

After ten minutes logging other features the “hedgerow” was seen to be erupting. At its northern end, where earlier the height was 37Mm, bright material had risen to 50Mm (arrowed x in Fig), with a faint plume reaching to 90Mm (a-a in Fig). The plume was visibly in motion, and over the next three minutes rose to 110Mm – when trees ended viewing. These numbers give an ejection velocity for the faint plume of over 100km/sec.- fast for a QRF that typically eject at 20-30km/sec.

The filament may have ejected entirely (all 200Mm of it) had it been visible for the next half hour or so, but trees hid it. A web search showed the SDO satellite EUV 171 Å channel had logged the event – confirming my record, but not showing if the ejection was total or partial. The SDO image, when enhanced, faintly showed the taller plume, dark against bright corona (a-a in Fig). Signs of a spot group behind the limb were noted ~15º north of the prominence (the future AR11223 site, AR? in Fig). There appear to be no other records of the event.

This was not a major ejection – far from it; but it reminds us that filaments eject from the sun on an almost daily basis at current activity levels. Having done so, a QRF will quickly reform, and it’s not unusual for part of a filament to erupt while the rest ‘stays put’. Nevertheless, it was exciting to watch, and reminds us that the sun, in H-alpha, is always active.

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