B2.1 NSP ServicesNSP services in the Northern Territory are overseen by the Sexual Health and Blood Borne Virus Program of the Territory Department of Health.
Primary outletsThere are two primary NSP services operating in the Territory – one in Darwin and one in Alice Springs. Both are managed by the NT AIDS and Hepatitis Council (NTAHC). The Darwin service has one fixed outlet at NTAHC in the city centre, and another at the rear of a shopping centre in the satellite town of Palmerston. The Alice Springs outlet is located at NTAHC's premises in the town centre. These services operate during business hours, Monday to Friday, and on Saturday morning; they supply equipment free of charge. They receive both Australian and Territory Government funding support. Paid and volunteer staff include a small number of Aboriginal workers.
Secondary outletsClean needles and syringes are available at night and at weekends from Accident and Emergency Services at the hospitals in four Territory towns – Katherine, Gove, Tennant Creek and Alice Springs; there is currently, however, no NSP service available through the Royal Darwin Hospital. Sexual Health clinics (Clinic 34) in Darwin and these other four towns serve as fixed secondary outlets during the day.
NSP services are also available through the Royal Flying Doctor Service at Uluru, but there is reportedly only sporadic demand, and little if any Indigenous use of the service.
PharmaciesAbout half of the Territory's 24 community pharmacies currently sell injecting equipment. Of eight Darwin pharmacies listed as selling injecting equipment, there are reportedly two which sell substantial amounts (of the order of 200 packs a month). NTAHC has recently received funding with the aim of increasing the number of pharmacies acting as secondary NSPs. One stakeholder described pharmacies as 'a weak spot' in the Territory's NSP coverage.
Some NT pharmacies purchase Fitkits that are made up for them by NTAHC at a cost price of $3 each; others purchase their own supplies from wholesalers.Top of page
User organisationNAP in Darwin provides an informal NSP to its own members and contacts ('a niche market'). Availability of injecting equipment through NAP was described as particularly important after hours.
The Northern Territory currently has no needle and syringe vending machines, and no NSP outreach services.
Mandatory prison screening for hepatitis C provides a form of surveillance in the Territory. Such screening reportedly shows infection rates of around 12%, with the overwhelming majority of those testing positive being non-Indigenous. Given a large Indigenous prison population, some stakeholders comment that this suggests currently low rates of HCV infection in the Territory's Indigenous community.
B2.2 Serving Indigenous clientsAround one-third of the Northern Territory population is Indigenous. The percentage of client contacts identified as Indigenous by NTAHC in Darwin has increased from around 5% to around 10% over recent years.
The Northern Territory currently has no specific policies or strategies relating to Indigenous access to NSP services, but there have been two recent projects (both funded by the Commonwealth and both managed by NTAHC) which have aimed to improve levels of engagement with Indigenous IDUs.
One of these - the Aboriginal and Torres Strait Islander Hepatitis C Awareness Raising Project - is an initiative based in Darwin, and began in mid-2006. It involves the employment by NTAHC of an Aboriginal hepatitis C project worker, and aims to raise awareness and enhance knowledge of the disease in Aboriginal and Torres Strait Islander communities, and with service providers interacting with Indigenous communities, in the Darwin urban region. Target populations include HCV-positive Aboriginal and Torres Strait Islanders, Indigenous injecting drug users, influential members of Indigenous communities, Top End urban transient and town camp populations, service providers interacting with Indigenous people such as youth workers, sporting organisations and alcohol and drug workers. The key focus is on getting messages on hepatitis C out to young people, and the project includes work in both juvenile and adult correction facilities. Building on an earlier, mainstream health promotion program, it uses a 'Hoops for Health' approach that involves an annual basketball challenge.
The stated objectives of this project are:
- to engage and establish effective relationships with Aboriginal and Torres Strait Islander Injecting Drug Users;
- to raise awareness and increase understanding of the concept of hepatitis C amongst Aboriginal and Torres Strait service providers and services serving Indigenous Australians;
- to increase the number of Aboriginal and Torres Strait islander people presenting for HCV screening, especially Injecting Drug Users;
- to increase knowledge of HCV issues in the target groups, particularly groups in correctional settings;
- to support Aboriginal and Torres Strait Islander clients who are HCV positive and provide referral to appropriate services for support and treatment;
- to raise awareness about the potential harms of injecting drug use and the impact of HIV and Hepatitis C on the individual and the community;
- to raise awareness of needle and syringe programs and safe injecting practices; and
- to promote networking and referral opportunities.