Philippa Jones - National Operations Manager – New Zealand Needle Exchange Programme (NZNEP) Philippa joined the NZNEP in 2020. She leads the National Office which is responsible for providing national leadership in harm reduction practice, services coordination, research and stakeholder engagement. Philippa has 25 years’ experience in the public sector.

Background: People who inject drugs (PWID) are a vulnerable population, facing barriers to social justice, socioeconomic support and healthcare. The stigma associated with injecting drug use commonly translates into negative healthcare experiences, leaving PWID reluctant to engage with mainstream healthcare services, including for COVID-19 vaccinations. The New Zealand Needle Exchange Programme (NZNEP), a peer-based service, received funding for a peer support project aimed at increasing vaccine uptake among vulnerable populations, including PWID. The NZNEP recognised it could increase access to hepatitis C services simultaneously with COVID vaccinations

Method: PWID living in smaller South Island centres and rural areas were contacted through staff at the NZNEP's seven South Island needle exchanges (NEXs). A peer navigator, with lived experience of injecting and HCV visited all locations to promote vaccination and HCV testing uptake. The peer navigator worked with NEX staff in each region to contact PWID clients, as well PWID attending other services such as probation, Māori (indigenous NZers) health services and pharmacies. Clients were incentivised (supermarket vouchers) to receive COVID vaccinations and boosters, and HCV point of care antibody tests (POCT), with the peer navigator administering the POCT, and navigating clients to follow-up HCV RNA tests and potential treatment. Clients were also incentivised to recruit friends and family for both HCV testing and vaccination uptake.

At six weeks 80 PWID (68% male; median age 47 [17-68]; 64% NZ European, 24% Māori) had participated. Of these, 24 PWID and four family members had received a vaccination or booster; 79 were administered an HCV antibody POC test, and five receiving an AB+ve result were referred to care.

Conclusion: A peer-led incentivised approach is demonstrating a high engagement for COVID vaccinations and HCV diagnosis in a vulnerable and hard to reach population.