Center for Disease Control:
“Hepatitis C is a liver infection caused by the Hepatitis C virus (HCV). Hepatitis C is a blood-borne virus. Today, most people become infected with the Hepatitis C virus by sharing needles or other equipment to inject drugs. For some people, hepatitis C is a short-term illness but for 70%–85% of people who become infected with Hepatitis C, it becomes a long-term, chronic infection. Chronic Hepatitis C is a serious disease than can result in long-term health problems, even death. The majority of infected persons might not be aware of their infection because they are not clinically ill. There is no vaccine for Hepatitis C. The best way to prevent Hepatitis C is by avoiding behaviors that can spread the disease, especially injecting drugs.”
Urban Survivor’s Union is committed to helping combat the spread of Hepatitis C in our communities. Our Greensboro and Seattle branches currently have commitments to test and treat people through grants and partnerships with public health initiatives.
USU Seattle (SE) our flagship chapter, works closely with People’s Harm Reduction Alliance, the largest peer run syringe exchange in the US. Washington’s Acute HCV rate was 0.4 per 100,000. Amazingly this beat the Healthy People 2010 goal of 1 case per 100,000, and they also began reporting cases of chronic HCV which very few states are doing yet.
All of this seems light years away from most of the US. USU SE models what USU aims to accomplish nationwide. We know that drug users must have a voice in decision making and policy making that affects their lives. USU-SE is advocating for the first Safe injection facility in the country, which will only further Seattle’s progress in reducing rates of HCV and improving drug user health. Methamphetamine injection is increasing in Seattle and this adversely affects HCV rates. Seattle advocated for and implemented a meth pipe exchange and a crack pipe exchange modeled after community based programs in Canada and Europe, designed to reduce rates of non injection behavior among drug users.
The Greensboro, High Point and Winston-Salem area has a population of roughly 1,611,243, with an estimated 8% (20,000) being PWID in need of injection-related services. This high prevalence of people who inject drugs in our tri-city area correspond to several NIDA studies reporting the number of people meeting the criteria in the DSM IV for heroin depedence doubled over the last few years.
The HIV outbreak in Scott County, Indiana should serve as a warning for North Carolina as we have conditions that are similar. Like Indiana, the counties we serve have high unemployment rates and substantial percentages of the population living in poverty, as well as a high prevalence of opioid analgesic injections, a paucity of injection-related services, and little to no HIV testing and health care access for People Who Inject Drugs. In Guilford County, six census tracts–three in Greensboro and three in High Point–had greater than 37.5% (and up to 63%) of households are below the federal poverty level and high percentages of adults do not have a high school diploma or equivalent. For example, Alamance County reports over 50% of their population ages 25 and older did not finish high school. Taken together, these risk factors/markers should serve as a plausible warning for another HIV outbreak among people who inject drugs in rural counties.
Human Rights Watch recently published an advocacy brief citing N.C. as “one of the states most profoundly affected by HIV.” Similar to what we report above, Human Rights Watch blames conservative attitudes, stigma, poverty, and lack of harm reduction programs for fueling the HIV epidemic in N.C. and the rest of states in the southern region of the U.S. Our data purports this to be true. The HIV infection rate in the rural county of Guilford is 23.5 per 100,000 and 14.6 per 100,000 in the county of Forsyth. These rates are 40% higher than the national rate. There are an estimated 35,000 people living with HIV in North Carolina. Most strikingly, one in three people who test positive for HIV already have AIDS, which demonstrate that people are not getting tested until their disease has progressed to AIDS.
The CDC estimates that there were approximately 17,000 new (acute) HCV infections in 2007 in NC, although the disease is rarely reported because individuals with new infections usually have no symptom. N.C. reported 122 cases of acute HCV in 2013 and, like other states, we do not track chronic HCV infections.
In keeping with this, Greensboro has recently undertaken efforts to create a program to combat this issue. The principal intent was to design and implement a multi-faceted approach directed towards reducing the burden of disease from viral hepatitis. They sought to do this by decreasing the incidence of new infections, decreasing risks for progression to chronic liver disease, improving screening activities for chronic and acute hepatitis, improving standard of care for viral hepatitis, and reducing barriers that stand in the way of treating active drug users. Focus also feel on ensuring that reinfection among the participants that were treated will be highly unlikely due to their being ensured access to sterile equipment, as well as adopting drug using behaviors that ensures the safety of our participants.
San Francisco Chapter is in an area where harm reduction has stayed ahead of the curve but the health disparities are so great that users in San Francisco felt compelled to come together and create a drug user union. Having heard about USU Seattle they contacted Shilo and the rest is history!
San Francisco has one of the largest HIV positive populations in the United States with a prevalence of 15,979. At the end of 2014, 9,567 of those individuals were living with AIDS. In 2014, there were 302 new HIV cases. 54% were between the ages of 30-49 years old. San Francisco is home to an estimated 16,000 injection drug users. There were 1,569 new cases of hepatitis C last year and around 12,000 cases of chronic HCV. The HIV rate is 13 per 100,000 however in the neighborhoods USU facilitates outreach the HIV rate is 294 per 100,000. San Francisco is struggling with major health disparities that our members are very interested in examining and determining the root causes of. USU is busy advocating for immediate action in these communities because we believe that everyone has the right and the desire to be healthy!
The statistics are alarming, black people only make up 6.6 % of the population yet they represent 11% of the HIV disease burden, 33% of the HCV disease burden and 23.5% of co-infections. Reducing HIV rates is an important part of reducing HCV because people with HIV are more likely to transmit the virus and HIV accelerates HCV disease. It is estimated that around 11% of Californians don’t know their HIV status. HIV and HCV Coinfection is another huge problem with 1/3rd of HIV positive individuals being infected with HCV and the majority of HCV is related to injection drug use. San Francisco health officials reported that crack users with no history of injection were presenting with elevated rates of HCV. San Francisco USU worked closely with Seattle USU advocating for, and then implementing a community ran crack pipe exchange similar to the model successfully used in Seattle to reduce HCV rates among non-injectors.
All three of our chapters are extremely valuable and have the ability to reach the people that need HCV services most.
Without our unions drug users lose their voice, they become powerless to affect change, and everyone suffers. We are an effective, transparent organization that has the ability to make a huge difference please help us