Peer-delivered hepatitis C testing and counselling: a means of improving the health of injecting drug users

We hypothesized that providing injecting drug users (IDUs) with free hepatitis C testing and counselling at a needle and syringe programme (NSP) would be an effective model. Between August 1999 and January 2000, our peer outreach worker offered these services from a busy NSP in western Melbourne. Over 300 counselling episodes were provided, and 47 IDUs who were not tested in the previous 12 months were given tests and full pre- and post-test counselling, and were inter viewed about reasons for not being tested, their knowledge of hepatitis C, and their risk behaviour. Twenty-eight IDUs (59.6%) tested antibody-positive, demonstrating the need to improve testing coverage and compliance with counselling requirements. Most were not tested because they did not think they were at risk, but their reported behaviour and antibody test results showed otherwise. Twenty people returned for a second interview, and improvements in their risk behaviour and knowledge of hepatitis C were detected. Our experience suggests that demand exists for hepatitis C testing and counselling of IDUs in Melbourne's western suburbs, that testing and counselling improve IDUs' ability to avoid harm, and that delivery of these services by a trained and experienced peer located at an NSP is an appropriate and effective model.