Health

16 HEALTH • Winter 2018 Connection between opioid use, HIV, hepatitis C, can complicate care \\ Livia Gershon FIGHTING DISEASE WITH COMPASSION "I was very apprehensive about utilizing services because I did not want to be seen or known or give out my information," she said. "They kept it very discrete…. They treated me like a human being." At that point, Nicole—who asked that only her first name be used here for privacy reasons—had no plans to quit. "I was on a path to self-destruc- tion," she said. "I was pretty hopeless. I think the shame overpowered every- thing, and I didn't see any way out." The staff at AIDS Project Worcester, known as APW, didn't demand that she think about quit- ting, Nicole said. They gave her syringes and snacks—she hadn't been eating much—and they listened without asking invasive questions or badgering her to enter treatment. The opioid crisis, and, particularly, the rising use of the synthetic opioid fentanyl, presents a public health danger in Central Massachusetts. Local health officials, nonprofit agencies, and health care providers, are working to prevent the spread of infections, particularly HIV and hep- atitis C, through infected needles. And one of their key tools is the kind of unconditional support Nicole received at APW. After months picking up syringes and talking with staff at APW, Nicole decided to enter a treatment program. She's now 14 months sober. But Martha Akstin, APW's director of pre- vention and screening, said the organi- zation believes every client is equally worthy of help and support whether they want to stop using or not. "We accept them where they are," she said. Along with serving people on site—Akstin said APW has more than 1,600 people enrolled in its syringe services program—the orga- nization does outreach in the com- munity. "We go to areas that we know active injection drug use is occur- I n 2016, a Central Massachusetts woman named Nicole was at a low point in her life. Her opioid use had taken a toll on her, physically, emotionally, and financially. When she hit a point where she couldn't afford $3 to buy fresh syringes at CVS, she turned to AIDS Project Worcester. Source: Massachusetts Department of Public Health, via Worcester Health and Human Services 0 50 100 150 200 250 300 350 '13 '14 '15 '16 '17 Worcester (Number of cases) City of Worcester (Rate per 100,000) Massachusetts (Rate per 100,000) 118 182 329 Hepatitis C cases Hepatitis C cases have edged up in Worcester in recent years. Hepatitis C cases Juliet L'Esperance, a health navigator at the AIDS Project in Worcester, which works to keep diseases from spreading through shared needles. P H O T O S / E D D C O T E

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