From March 6-8 2016, people living with Hepatitis B and C
[HVB and HVC] and allies from around the country will converge in Washington, DC to take part in “Hepatitis on the Hill,” an advocacy event aimed at educating legislators about hepatitis and garnering support for increased federal funding for hepatitis prevention, screening and treatment.
Hepatitis is a virus transmitted through blood sharing and sexual contact that attacks liver cells, and chronic hepatitis is the leading cause of liver cancer globally. While the number of deaths caused by hepatitis in the United States surpassed those caused by AIDS-related infections in 2007, hepatitis screening, prevention and treatment remain underfunded, and over half of those living with hepatitis do not know they are infected. HVB can be vaccinated for but not cured, yet only 25% of US residents have been vaccinated. HVC can be cured but not vaccinated against, yet treatment is expensive ($94,000-$40,000 per patient) and out of reach for many, with medicare and private insurance often prohibiting treatment for substance users and withholding treatment until late stages of HVC.
Banning HVC treatment access for substance users is especially problematic, given that injection drug users bear a vast portion of the HVC burden, in the United States and globally. An estimated 60-80% of IDU globally are living with a chronic HVC infection, and of the 3.5 million individuals living with chronic HVC in the United States, an estimated 1.6 million had acquired it through injection drug use. As a portion of sex workers, especially street-based sex workers, are also injection drug users, expanding access to HVB vaccination and to HVC treatment and other prevention resources, like sterile syringes (including syringes used by trans* sexworkers for hormone injection) and clean injections supplies, is a central sex worker issue. Further, because sex workers face additional risks related to repeat exposure, we support universal HVB vaccination and early HVC treatment as imperative to eliminating community HVB and HVC viral loads and ending chronic hepatitis among sex workers.
We also feel it is crucial for hepatitis advocates to remember disparities in vulnerability among injecting drug users. Multiple studies have identified engaging in survival sex work as a primary risk factor for acquiring hepatitis among injection drug users, along with other risk factors common among survival sex workers, such as housing instability, race, gender, and incarceration. For these groups, better and broader bio-medical interventions are not enough. It’s imperative to also address the wide range of structural factors that put some at greater risk for both hepatitis exposure and chronic hepatitis acquisition: gender-based barriers to syringe exchange access and avoiding sharing injection supplies including syringes, cookers, cottons and waters, sexual violence, the absence of harm reduction materials in correctional facilities, housing instability, poverty, racial profiling and criminalization.
“Hepatitis on the Hill” is co-organized by the National Hepatitis Roundtable, Hepatitis Appropriations Partnership, and Hep B United. SWOP-USA Board members Katie Jares and Magalie Lerman will be participating in the event. For additional information about the advocacy event, hepatitis, and how to support expanded screening, treatment and prevention, visit the event website.