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Engaging Aboriginal people in viral hepatitis, HIV and sexual health services

The Deadly Liver Mob (DLM) is a health promotion program that aims to promote a holistic approach to healthy living by providing Aboriginal people with bloodborne virus (particularly hepatitis C) and sexually transmissible infection (STI) education, as well as screening, testing and referrals into treatment. The DLM includes a peer-driven intervention that aims to reach the Aboriginal community in the area, raise awareness of hepatitis C transmission risk factors, increase access to testing and treatment and provide a point of entry to other health services among this group.

The DLM program has been running in Western Sydney Local Health District (LHD) since 2013 and Nepean Blue Mountains LHD since 2015. The program came about as a result of low attendances at the NSP by Aboriginal people (against a background of recognised increasing injecting drug use in the area) and very few episodes of care over the immediate preceding years in the adjacent sexual health clinic, despite being one of the most populous areas for Aboriginal people in Australia. In its first 12 months, DLM engaged more than 400 Aboriginal people in HCV health promotion with subsequent referral of over 300 people to sexual health screening, resulting in a 1023% increase in access to sexual health services.

The DLM program is now being rolled out to several new LHD sites. This NHMRC Partnership project will evaluate the rollout to new sites while continuing to monitor progress in the existing two sites. The overall goal of this partnership project is to evaluate the health outcomes and impact of the DLM, examine its acceptability and establish a translational framework that would enable the DLM to be scaled up across New South Wales and further afield. This is a mixed-methods evaluation, collecting data from existing, routinely collected data sources and semi-structured interviews with DLM clients and health workers. These data sources will assess:

1. the reach and engagement of the DLM with Aboriginal people in the study area and how this engagement influences screening, testing and treatment rates
2. perceptions of the project among Aboriginal participants
3. perceptions of the project among health workers in relevant LHD services
4. the impact of the DLM on attendance and retention of Aboriginal clients in relevant LHD services.