Tom Wright is currently the Harm Reduction Coordinator at Justice Health and Forensic Mental Health Network. Tom has previously worked across a number organisations in roles focused on Harm Reduction, Homelessness and Justice.

Background
In 2016 Direct Acting Antiviral (DAA) treatment for Hepatitis C became available to people in Australian Prisons. In New South Wales health services in the 32 publicly operated prisons are provided by Justice Health and the Forensic Mental Health Network (the Network). Since 2016 the Network has rolled out a comprehensive DAA treatment program and as of June 2022 had provided over 5400 treatments. The increase in testing and treatment rates also provided an opportunity to enhance our data surveillance of new infections.

Approach
The Network has developed a robust process to identify people who have received DAA treatments multiple times, clinically review these occurrences to identify new infections and link this to relevant demographic and custodial data items.

Outcome
The Network has now provided 1100 re-treatments with DAA’s, 761 of these have been confirmed as a new infection post cure. 170 people have been treated three times, 28 people have been treated four times and 5 people have been treated five times.
292 people have been confirmed as acquiring these new infection when inside a NSW Prison. To date 20 people have been identified who acquired a new Hepatitis C infection twice during the one custodial sentence.
Aboriginal and Torres Strait Islander people are shockingly over represented in the retreatment data representing about 60% of all re-treatments.

Conclusion
New Hepatitis C infections occurring in NSW prisons demonstrate that despite efforts to strengthen access to disinfectants, education and Opiate Agonist Therapy more needs to be done to bolster Harm Reduction. Strategies that better engage with and protect Aboriginal and Torres Strait islander people from Hepatitis C in Australian prisons must be a priority.