Project Overview

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 Sixth National Hepatitis C Strategy 2023-2030. 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 treatment 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.

Aims

The aim of this study is to co-design and pilot a targeted intervention for people who inject drugs living in regional settings to support the prevention and management of hepatitis C.

Objectives

This study has the following objectives: 
1. A survey of PWID 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.  
2. 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 to understand successes and 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.  
3. Co-design and pilot at least one Phase 2 intervention.

Significance 

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. 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, support action to reduce hepatitis C transmission and deliver health care savings.

This project will be based in the Collaboration for Evidence, Research and Impact in Public Health (CERIPH), within Curtin’s School of Population Health (SoPH). Located within CERIPH, the Sexual Health and Blood Borne Virus Applied Research and Evaluation Networks (SiREN) works with researchers, policymakers and practitioners towards an evidence-informed approach to sexual health and bloodborne virus priorities. The scholar will work alongside and be mentored by CERIPH/SiREN PhD scholars and researchers. SiREN maintains a network of 400+ professionals and its steering group comprises senior representatives from agencies including Peer Based Harm Reduction WA, Royal Australian College of General Practitioners, HepatitisWA, the Aboriginal Health Council of Western Australia and WA Health. The scholarship will build deeper WA and SoPH research capacity in infectious diseases and rural health. Research will progress goals of the WA Hepatitis C Strategy, WA Alcohol and Drug Interagency Strategy, National Drug Strategy and Fifth National Hepatitis C Strategy. Research is congruent with the enAble Institute’s vision - research to meet the physical and mental health needs of people, and live personally meaningful and enriched lives.
 

An internship may be available for this project. The supervisory team have established partnerships with NSPs in WA and with the Department of Health WA Sexual Health and Blood Borne Virus Program that funds NSP services. These organisations have hosted previous student placements and the candidate will complete an internship with one or more project collaborators, gaining experience across policy and practice.

• Future Students

• Faculty of Health Sciences

• Higher Degree by Research

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

• Merit Based

The annual scholarship package, covering both stipend and tuition fees, amounts to approximately $70,000 per year.

In 2024, the RTP stipend scholarship offers $35,000 per annum for a duration of up to three years. Exceptional progress and adherence to timelines may qualify students for a six-month completion scholarship.

Selection for these scholarships involves a competitive process, with shortlisted applicants notified of outcomes by November 2024.

1

All applicable HDR courses.

• Public health, health promotion, social or behavioural sciences background. 
• 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 intrastate

 

Please send your CV, academic transcripts and brief rationale why you want to join this research project via the HDR Expression of Interest form to the project lead researcher, listed below. 

You must be enrolled in a Higher Degree by Research Course at Curtin University by March 2025.

Project Lead: Dr Roanna Lobo