Here’s my interview with Patrick Hoffmann, health inspector, Health Directorate in Luxembourg and partner in the HA-REACT Joint Action.
What influenced your decision to become involved with the newly formed Joint Action on HIV and Co-Infection Prevention and Harm Reduction (HA-REACT)?
The Joint Action is quite an interesting challenge as it engages in European-wide collaborative work throughout the different focus topics: HIV, viral hepatitis and tuberculosis. Although many positive efforts and improvements have been made in the past, there are still major inequalities throughout the European Union and within the primary risk population groups such as people who inject drugs and prisoners. Sharing knowledge and experiences from our respective countries is a good opportunity to help the focus countries (Hungary, Latvia and Lithuania) change their policies and approaches to these topics.
How do you see your role in your particular work package, “Harm reduction and continuity of care in prisons”?
Personally, I have 12 years of experience in the field of harm reduction measures in prisons working as a nurse. This is an example of the richness of backgrounds that the Joint Action partners have to offer.
My home country of Luxembourg, for example, is a good example of practices in this field because of their dedication to harm reduction in the prison system. In the Joint Action I want to specifically highlight the barriers we faced in our country and share how we overcame them over time. This is because, in my experience, these problems tend to be similar, or at least comparable, in most countries. Sharing experiences in this way has already begun with many different activities. An upcoming two-day workshop for key stakeholders in the field will be held in June 2017 in Luxembourg on needle and syringe programs (NSPs) in prison settings.
From your perspective, why focus on HIV, TB and viral hepatitis in Europe?
We can only eliminate or stop the spread of these diseases if we work together with the same evidence based measures
Prisoners are known to be a high-risk group for these diseases. Prevalence within prisons is much higher than in the general population and transmission from prisoner to prisoner is rampant. Treating people in prisons is a good opportunity for micro-elimination and control of these infectious diseases and is an important public health measure as new infections can be prevented. We can only eliminate or stop the spread of these diseases if we work together with the same evidence-based measures; therefore a great deal of conviction is needed from stakeholders.
What can we expect as a result of your HA-REACT work?
A comprehensive summary of good practices (e-learning tools, booklets, etc.) will be available for public use and will be a useful advocacy tool. Exchanges with experts are facilitated for stakeholders and helps influence a change of mindset as a result of the range of parallel experiences and data presented. The end goal is, of course, a reduction (eventually elimination) of these three diseases and with enough collaboration this is an achievable target.
What does the project hope to achieve over the next 3 years?
If we can achieve a broad change in outlook in the approach to stigmatized populations, the repercussions can only be positive
Over the remaining two years the project hopes to impact the spread of these diseases as we continue down the path to elimination.
Being realistic, if we can achieve a broad change in outlook in the approach to stigmatized populations, the repercussions can only be positive. The new HCV treatments (direct-acting antivirals) can help us to treat and cure many more people from high-risk groups, even as financial and other barriers remain. HIV treatments should start as soon as possible after patients are diagnosed in order to interrupt the spread of infection, especially those from high-risk groups. These interventions should happen in prisons as well as outside of them.
The HA-REACT Joint Action will have a European-wide impact on these goals and hopes to bring stakeholders together in cooperation in order to achieve these objectives.
The Joint Action aims to contribute to the elimination of HIV and reduction of TB and viral hepatitis among PWID in the EU by 2020 and focuses on member states with gaps in effective and evidence-informed interventions. The project also encourages the implementation of comprehensive harm reduction programs in all EU member states as an essential strategy for improving the prevention and treatment of HIV, TB and viral hepatitis. Further information about HA-REACT is available at: https://www.hareact.eu/en
Hepatology, Medicine and Policy is now accepting submissions on this and related issues. For more information, visit: www.hmap.biomedcentral.com.