Five Years of CNP Peers

Among its other services,

Hepatitis SA runs four Clean Needle Program (CNP) sites in Adelaide, at Hackney, Noarlunga, Port Adelaide, and Salisbury. Our CNP peer educators also attend rostered sessions at other sites at various times during the week. In late 2019, we celebrated this program’s fifth successful year, which would have been impossible without the hard work and dedication of our peer educators, who have personal experience and knowledge of injecting drug use and also have up-to-date knowledge on hepatitis B, hepatitis C and other bloodborne viruses. We asked some of our peer educators to reflect on how they came to the job, and what rewards they find in it.

What first made you want to be a peer worker at Hepatitis SA? PENNI: I first wanted to be a peer worker at Hep SA when they adopted CNP management—due to the focus on blood-borne viruses, this made sense. I was already familiar with the roles of CNP operator and peer educator, really enjoyed and felt fulfilled in the position, and felt an affinity for the work and the clients. I wanted to continue my existing employment as a CNP peer along with my existing part-time peer educator role with HepSA, so I was fortunate that I could perform both roles on a part time basis, plus the subject matter overlapped, permitting me to engage

in both CNP and HCV peer education work. I could bring skills from either specific role to help the other.

MARGIE: I became a peer worker because I wanted to help drug users get the correct information about how to use drugs and do the least amount of damage to your body and mind while doing it. I started using in the 1980s, when the only information came from other users. There were no CNPs, no Google, so you learned from others. We bought equipment from medical supplies shops. We bought glass barrels called Blue Ladies, and boxes of tips. There was no swabbing that I can remember, and we used the tips over and over

To see how our CNP services have changed during the COVID-19 outbreak, please see p12.

until they wouldn’t push through the skin anymore. We shared everything, though we did rinse the equipment a lot in between each use. As I owned a Blue Lady I got to go first—a big plus. When I moved to Sydney there was one chemist to get equipment from, in the Cross. Police sat outside taking photos of everybody going in and out, so we would go as little as possible. We all shared equipment. Nearly everybody I knew had what was then called Hep Non-A Non-B, which we now know is hepatitis C. We had no idea you could get different strains—they didn’t have a name for it or any information. Then AIDS hit and sharing became a game of Russian roulette. Many didn’t win. Then in 1986 the first needle exchange—that’s what we called them—came in. It was a life-changer. Not only could you get new equipment, you could get advice and information. If I remember correctly it was in an old police station! At that time I asked if I could volunteer there because I thought it was an amazing service. They didn’t have peers at the time so I was given the job of making up 10-packs. I didn’t last that long as I was put in a room alone and, to be honest, I got bored. Life moved on and I didn’t really think about working in CNPs or being involved until I came to South Australia. I was told about SAVIVE and started volunteering there. It was great to be around people that felt the same about treating drug users with respect and offering as much information as I could to keep them safe. When a job came up at Hep SA as a peer educator, I jumped at the chance to apply.

BERNADETTE: I worked as a peer educator when the AIDS Council was funding the SAVIVE and SIN programs. I jumped at the opportunity to work for Hepatitis SA when it was provided with funding to continue to run the peer program—it’s very rewarding work and I knew how important the program was. I applied to do casual/relief work when Hepatitis SA advertised. I enjoyed my role at SIN doing street outreach, providing condoms and needles to street-based sex workers and educating them on keeping safe while working, providing education to prevent them from contracting BBVs, and educating them about ways in which they could minimise harm to themselves and make educated choices—again, to prevent the spread of BBVs. I also provided education on how to care for their veins by using sterile water, filters, swabs, and a new fit every hit, in order to prevent vein damage or a dirty hit. We also provide information about hepatitis and how hardy the virus is, education on not sharing tourniquets, spoons or mixing up in the same bag, and not sharing vein care cream or toiletries such as shavers, toothbrushes, or nail clippers.

SUE: I had been a peer worker for about 10 years when the AIDS Council, which used to fund the SAVIVE and SIN injecting drug programs, closed down, so I came to work for Hepatitis SA. Being a peer worker fulfilled me with work that I found myself good at. I have learned to listen, and to give the clients some referral advice in the areas that might help them. However, I cannot do the job for them, and I believe we need more advocates to assist people lost in their

own depression or lifestyle choices. We peers have all been around for a number of years now, so we have all have a great rapport and trust with our clients.

JUSTIN: Working with my community is such a rewarding experience. Given my own early interactions with CNPs, being able to step into that role and provide information and education to people that they simply can’t access anywhere else was so important. Without harm reduction education it can be very difficult to appreciate what can be important practice and what are myths. Given the taboo nature of injecting drug use, so many of the harms arise from stigma, and from the prohibition of substances as opposed to the substances themselves. Helping people understand this not only gives them the tools to not cause detrimental harms, but also to be proud of who they are. We help show people they have options, and that they can live happy and healthy lives whether they continue to need our service or not.

What have you found most rewarding about the role? PENNI: I feel lucky to be in part-time employment where the work is 100% interesting, worthwhile, enjoyable, and utilises personal skills, experience and aptitudes. Working as a peer with other peers allows you to grow in the workplace with like-minded and supportive people, where your goals and objectives are meaningful, and the subject matter has relevance for yourself and others, and where the client group is one for whom I have a strong affinity. Interactions with the clients are positive, whether we’re providing assistance or simply exchanging a few words or a laugh. Being able to operate with autonomy in pursuit of these extremely worthwhile goals is highly rewarding. I actively and regularly appreciate numerous aspects of this CNP peer ed role with Hep SA.

MARGIE: The most rewarding thing about being a peer worker is being able to share my knowledge and experiences with service users. I’m able to give them a piece of information that could change their quality of life, whether it is as simple as explaining swabbing to them or just having a chat with them. That piece of information will then get shared amongst their friends, increasing their knowledge and keeping them from harm. Many come in with serious problems—they don’t want you to fix it, they just want to be able to talk to someone who isn’t going to judge them or dismiss them. When they know that you have used drugs there is almost a sigh of relief because they don’t have to defend their life choice. We have something in common that lifts a veil, they become more honest and open about asking advice. I want that person to walk out after having had a good interaction with a service provider and knowing they can ask me anything. I also find I learn things from clients, they tell me about their lives, equipment and what’s happening in their community. I would love to keep doing this and keep learning for as long as I can.

SUE: The most rewarding thing about this job has been the confidence we give to our clients when we inform them of information they are clearly very worried about.

One regular client came in, distressed that his doctor had just informed him that he had hep C, and he was threatening suicide! I was distraught with that comment and went into overdrive giving him information about the disease and how now was the best time ever

to get cured, as the new medications had been in the community around six months by then, and success rates were astronomic… So I gave my client all this information and managed to calm him down, got him an appointment with a liver nurse, and he went on the medication and within the 12-week period he was cured, and he was over the moon. I haven’t had many interactions with clients like that one, but knowing we are acknowledged by them means an awful lot.

BERNADETTE: I find the feedback that we receive from clients to be a reward in itself. For example, to hear how comfortable they felt using our services and how they could openly talk about any issues they were having. Clients often relay how they like using our services because we are peers and have lived experience. They like that we not only can talk the talk, we walk the walk. The most positive feedback is clients saying how they know we are not judging them. They compare our program and services with other programs and say how they can see that even though often they are receiving their equipment needs, that they don’t feel like they can openly ask for advice, as the staff don’t have the experience to answer their questions, or they feel rushed or judged. Some of our long-term clients actually call in when they don’t need equipment just to say hello, or will make a point of having a chat about what’s happening in their life in general. Clients will often share with us how helpful another peer was or how we really helped them or changed the way they were feeling that day, just by being friendly and approachable, or because we took the time to listen, or we could see they seemed stressed, so we asked them if they were OK. A smile costs nothing but gives so much. What other job is there where we are recognised for and able to share our own lived experiences with our peers and not only are we encouraged to share this, we are recognized as “experts” and given the title of Peer Educator?

JUSTIN: Being “out” in a workplace as someone who has used drugs is an interesting experience—it has broken down barriers with so many people across the many agencies I have worked in. Drug users are usually portrayed and understood in a very narrow way, but by being a trustworthy and capable co-worker and caring about our clients, co-workers and workplace, it only takes a small amount of time to show people that those assumptions are wrong. It is most rewarding seeing people who might have once been afraid of, or scowled at the idea of drug users, now accepting and welcoming us as clients and members of the community. We thank all of our peer educators for their hard work, and for taking the time to talk to us about it! v