B4.1 CNP ServicesClean Needle Program (CNP) services in South Australia are overseen by Drug and Alcohol Services South Australia (DASSA), a state-wide health service that sits within the Southern Adelaide Health Service.
Primary outletThere is only one primary CNP outlet in South Australia, run by the South Australian Voice for Intravenous Education (SAVIVE) peer education program – an arm of the AIDS Council of South Australia. This service is located in the Adelaide suburb of Norwood.
Secondary outletsThere are 68 secondary CNP sites across the State. These are sites that are not specifically staffed by CNP workers, but are run by staff at health and community service agencies as an ancillary service to their main business. Sixteen of these 68 secondary sites are located in metropolitan Adelaide and 52 in regional and rural South Australia. SAVIVE employs workers who operate at a number of secondary outlets across Adelaide.
In rural and regional areas the large majority of secondary services are provided through hospital Accident and Emergency Departments.
Secondary enhanced outletsThere are currently eight secondary enhanced CNP outlets, in which there is a dedicated CNP worker located within a high volume site. All of these sites are in metropolitan Adelaide.
Outreach servicesThere are three Outreach CNPs currently operating in SA; Outreach services target more marginalised groups of injecting drug users. Evidence quoted by DASSA suggests that providing CNP services through an outreach mode of service delivery is the best way to reach injecting drug users who engage in risky injecting practices and are at increased risk of blood borne virus transmission – for example Aboriginal, homeless, young and sex worker IDUs5. The three outreach services include one which targets Aboriginal and homeless people in inner city Adelaide; another targeting street-based sex workers in Adelaide's western and northern suburbs; and a third targeting Vietnamese drug users in the western suburbs.
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PharmaciesThe CNP Pharmacy Scheme, developed in collaboration with the Pharmacy Guild (SA Branch), offers pre-packaged injecting equipment for purchase at over 180 pharmacies across the State. Many pharmacy outlets also provide a sharps waste disposal service for the return of injecting equipment. To be classified as a CNP, pharmacies must sell needles and syringes with a sharps disposal container with all transactions. Pharmacies sell a variety of packs of needles, syringes and disposal containers for between $5 and $10. Some pharmacies also provide sharps disposal facilities.
B4.2 Serving Indigenous clientsCNP sites are not required to collect data on Aboriginality as part of the mandatory statistics gathered for each CNP client transaction, unless they are specifically funded (like the Nunkuwarrin Yunti health service in Adelaide) to engage Aboriginal people who inject drugs. However, a Client Satisfaction Survey that is conducted annually at seven of the busiest CNP sites asks participants whether they are of Aboriginal or Torres Strait Islander origin. In 2007 approximately 6% of participants identified themselves as of Aboriginal or Torres Strait Islander origin.
DASSA conducted a 4-year project, finishing in 2007 (the Access and Expansion Project), that was designed to promote improved access to CNP services for three specific groups namely young IDUs, IDUs of CALD background, and Indigenous IDUs. One aim was to increase participation in the CNP by appropriate services, including Aboriginal Medical Services. Although a small number of new services were developed, there was little overall progress in increasing AMS participation in the CNP.
With regard to specific services for Aboriginal people, there are currently five CNPs that are located within Aboriginal-specific health services in South Australia. Two of such services are located in metropolitan Adelaide: one of these is in the northern suburbs and operates a secondary CNP, while the other is located in the CBD - at Nunkuwarrin Yunti – and provides both a fixed site and outreach CNP services. DASSA provides funding to support the outreach service that targets homeless Aboriginal people who inject drugs.
In regional South Australia there are CNPs located at Aboriginal-specific health services in the Riverland, Port Augusta and Ceduna. Port Augusta and Ceduna are fixed site services operating within a sobering up service; in the Riverland the CNP is part of an outreach health service.