love what I do ,’ Paul

Huggett , peer coordinator for the Hepatitis C Trust , told the Positive about being positive session

at HRI ’ s Constellations harm reduction festival . ‘ When I give someone the diagnosis that they ’ re positive but then tell them I ’ ve had it , they say , “ but you look well ”. I say , “ exactly ”.’

There had been a significant year-on-year increase in the number of people being treated since 2017 , said Hepatitis C Trust regional manager , Danny Morris , but there was still a long way to go when it came to reducing

‘ I ’ ve booked people several appointments and two years later they eventually say they ’ re ready to do it . They ’ ll come round in the end .’

NATHAN MOTHERWELL

chronic infections , particularly in the wake of COVID-19 . Rates of equipment sharing , meanwhile , were still around 25 per cent – ‘ a big , big concern for us ’ – and around half of those living with hepatitis C were still unaware of their status . The trust delivered peer projects across the UK , he said , working closely with hepatology teams , drug and alcohol services , homelessness services and prisons , with the majority of staff having lived experience . One vital aspect of their work was modifying and speeding up pathways into treatment , particularly for more marginalised communities .

INDIVIDUAL NEED ‘ That ’ s a big part of it ,’ said Nathan Motherwell , a peer coordinator for the trust . ‘ For example , they don ’ t write to homeless people at the drug service anymore .’ He helped to make sure that treatment was adapted to suit people ’ s individual needs and coordinated and recruited other peers , using his experiences to build rapport with his clients . ‘ I was a very chaotic drug and alcohol user , but all of the things I experienced – even including prison – have ended up being useful in some way . When I talk to people I say , “ I used to do that ”, and it breaks down some of that shame .’

Elimination was now becoming a reality , partly through treating whole communities of injecting drug users in different locations – ‘ we ’ ve probably significantly reduced the risk of anyone getting hep C in the Medway towns over the last three years .’ The key was to ‘ be persistent and don ’ t take it personally ,’ he said . ‘ Sometimes people don ’ t want to engage . I ’ ve been sworn at when people are busy trying to score , I ’ ve booked people several appointments and

two years later they eventually say they ’ re ready to do it . They ’ ll come round in the end .’ There was often an intense level of support needed , particularly for clients with dual diagnosis , and this involved working closely with other agencies . ‘ These are the people with the highest risk of reinfecting themselves or infecting others . But we ’ ve got good outreach teams and they know these people .’

People often lied , he said , partly because of the shame . ‘ But if you break down the practice – who they use with , when , where and how , you can often change one little bit and that might help .’ This could be something as simple as getting people to carry their own equipment , spoon or bottle of water . ‘ Some of the peers are still on methadone scripts so they ’ re a lot closer to where people are at , and have managed to engage people that I couldn ’ t .’ Clients were also encouraged to find other people for testing in exchange for vouchers , he said – ‘ sometimes people will turn up with five others .’

EDUCATION AND PREVENTION Education and prevention were vital , said Huggett , who was in active addiction for 20 years . ‘ We all know it ’ s full of fear and stigma , but if you start talking about it , it eases all that stuff .’ Having a regular presence at hostels and drop-in centres for testing days was also crucial , he said . ‘ If they keep seeing us , eventually they ’ ll get tested .’ It was about ‘ being consistent with love , care and compassion – they ’ re going to come round and we ’ re going to get them .’

He coordinated a team of four peers with eight volunteers , and a current project involved targettesting in a pharmacy . ‘ The more testing you do , like with COVID ,

‘ When I give someone the diagnosis that they ’ re positive but then tell them I ’ ve had it , they say , “ but you look well ”. I say , “ exactly ”.’

PAUL HUGGETT

the more positives you find .’ But it was then vital to make sure the right level of support and care was in place to get them through treatment . ‘ Gold standard is not knowing they ’ re positive and leaving them out there .

THE BEST JOB ‘ It ’ s about more than hep C ,’ he stated . ‘ Once they told me I ’ d got the all-clear it made the impossible possible . It made getting stable on a script seem doable , even sobriety seemed achievable . Because I ’ d just beaten a killer disease . I ’ ve got the best job in the world because every week I ’ m telling people they ’ ve got the all-clear from hep C .’ DDN