Australia is aiming to eliminate hepatitis C as a public health threat by 2030. This elimination goal is in line with global targets set by the World Health Organization (WHO) and targets included in Australia's National Hepatitis C Strategy 2018–2022. Modelling by the Burnet Institute suggests that hepatitis C testing in Australia would need to increase by at least 50% for the WHO elimination targets to be achieved. 

A key area for action in the National Blood-Borne Virus and Sexually Transmitted Infections Research Strategy is to “address knowledge gaps to build the evidence base to inform future priorities for health policies and programs and ensure linkage and alignment with priority areas”. People who inject drugs (PWID) are a priority population and regional areas are priority settings, however there is a dearth of literature on the needs and behaviours of PWID outside of major urban centres in most states. Western Australia (WA) has the largest volume and proportion of land classified as remote or very remote (Australian Bureau of Statistics, 2016). This has implications for the control and management of hepatitis C (HCV), including accessibility of needle and syringe programs (NSPs). NSPs can reduce transmission of HCV through providing sterile injecting equipment to PWID and encouraging HCV testing and treatment.  

The challenges in providing care to people with HCV in regional areas - coupled with the fact that age standardised rates of newly acquired hepatitis C in the Kimberley, Pilbara, Goldfields, Great Southern and Midwest regions are higher than or comparable to the rates in metropolitan Perth - suggests that prevention activities are particularly important in regional areas. While there is a priority under the Strategy for “equitable access to successful preventative measures for all priority populations, with a focus on sterile injecting equipment through NSPs,” we have limited knowledge about whether the needs of PWID and access to NSPs in these regions are being met.
The aim of this study is to co-design, pilot and evaluate a targeted intervention for people who inject drugs living in regional settings to support the prevention and control of hepatitis C. 

This is a three-phase study. Phase 1 will be a survey of PWID in regional WA to understand: (1) the extent and nature of sharing injecting equipment; (2) barriers to, facilitators of and preferences around accessing sterile injecting equipment e.g. NSPs, vending machines, via pharmacies or outreach; and (3) HCV knowledge and testing practices. Phase 2 will comprise qualitative interviews/focus groups with PWID, and with staff from regional NSPs, pharmacies, hospitals, public health units, alcohol and drug services, and Aboriginal community-controlled organisations. The aim of Phase 2 is to understand successes/challenges in the provision of sterile injecting equipment and HCV testing in regional WA, with a view to recommending service/system-level improvements and co-designing targeted intervention(s) to increase NSP and HCV testing accessibility among regional PWID. In Phase 3, at least one co-designed Phase 2 intervention will be piloted and evaluated.

It is anticipated that the survey findings, interview recommendations, and the co-designed piloted intervention will support increased access to sterile injecting equipment in the regions, which will, in turn, reduce hepatitis C transmission and result in savings to the health care system. It is well-recognised that NSPs are a cost-effective public health intervention. As noted in the Hepatitis C Strategy, “[p]ast modeling over a 10-year period estimated that over 96 000 new hepatitis C infections were averted and, for every one dollar invested in NSPs, more than four dollars were returned (additional to the investment) in direct healthcare cost savings.” Savings associated with the prevention of new HCV infections are likely to be even higher in regional areas where staffing costs are higher and there are difficulties in realising economies of scale (Palmer, Appleby and Spencer, 2019).

The evaluation of the targeted intervention to reduce risks of HCV transmission among PWID living in regional areas will also contribute to building the evidence-base around ‘what works’ with respect to this under-researched cohort, and will help to inform decision-making about whether national scale-up is likely to be effective. While it is known that NSP effectiveness in relation to reducing HCV transmission is enhanced when accompanied by multi-component, harm-reduction interventions, there is a dearth of evidence on what types of interventions are feasible and effective in regional settings. 

• Future Students

• Faculty of Health Sciences

• Higher Degree by Research

• Australian Citizen
• Australian Permanent Resident
• New Zealand Citizen
• Permanent Humanitarian Visa

• Merit Based

The annual scholarship package (stipend and tuition fees) is approx. $60,000 - $70,000 p.a.

Successful HDR applicants for admission will receive a 100% fee offset for up to 4 years, stipend scholarships, valued at $28,854 p.a. for up to a maximum of 3.5 years, are determined via a competitive selection process. Applicants will be notified of the scholarship outcome in November 2022. 

For detailed information, visit: Research Training Program (RTP) Scholarships | Curtin University, Perth, Australia.

1

All applicable HDR courses

• a background in public health, health promotion, social or behavioural sciences.
• interested in community facing, policy relevant research.
• have experience or interests in mixed methods research.
• strong project management skills.
• strong verbal communication and interpersonal skills.
• ability to work independently and as part of a team.
• live in Western Australia with the ability to travel intra and interstate COVID-19 permitting. 

If this project excites you, and your research skills and experience are a good fit for this specific project, you should contact the Project Lead (listed below in the enquires section) via the Expression of Interest (EOI) form. ahead of the closing date.

Eligible to enrol in a Higher Degree by Research Course at Curtin University by March 2023

To enquire about this project opportunity that includes a scholarship application, contact the Project lead, Dr Roanna Lobo via the EOI form above.