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Learning Objective:
By the end of the presentation participants will be able to:
1.Consider onsite drug treatment as a conduit for preventative measures such as HBV vaccination
2.Consider immediate vaccination prior to testing
3.Consider accelerated vaccination strategies to improve retention in 3 vaccines
Background:
Injection drug users (IDUs) are at high risk for Hepatitis B virus (HBV). One barrier to vaccination is active substance use. Individuals actively misusing substances often do not come into contact with primary care providers and typically utilize emergency departments and urgent care sites such as mobile clinics, walk-ins, etc. Such sites of episodic care often do not consider vaccination with hepatitis B to be a priority. The introduction of buprenorphine allows for the introduction of opiate agonist treatment directly into syringe exchange sites and offers the possibility of bringing into medical care individuals who would otherwise not enter care until intercepted by admission through an ED to the hospital or the courts.
Setting:
IDU patients whose drug of choice is opiates and who use mobile health care services linked to SEP in New Haven are routinely offered entry into Project BEST (a SAMHSA funded program designed to use buprenorphine as a conduit to bring out-of-treatment substance users into treatment).
Population e.g. API Youth, MSM, IDU:
IDU
Project Description:
The Community Health Care Van (CHCV) is a mobile health program providing acute treatment and preventive health care proximate to NEP sites. IDU are screened for a number of conditions, including HBV infection.
Results/Lessons Learned:
Screening data (N=69):
HBsAg+ = 6 (9%)
HBsAb+/HBcAb- = 9 (13%)
HBsAb-/HBcAb+ = 15 (22%)
HBsAb-/HBcAb- = 39 (57%) Eligible for vaccination
The use of buprenorphine may assist in the stabilization of patients so that they may engage in routine health care (e.g., HIV, HBV). It likely reduces risks for transmission of blood-borne pathogens and allows repeated encounters in order to initiate and complete vaccination.
See more of A3 - Vaccination Strategies for Injection Drug Users
See more of The 2005 National Viral Hepatitis Prevention Conference