Editors' Introduction Evolving Knowledge and Practice: Hepatitis C and Illicit Drug Use
Hopwood, Max, Bryant, Joanne, Brener, Loren, Contemporary Drug Problems
The exponential rate of development in science and technology in recent decades has had a profound social impact. In particular, computing and the Internet have indelibly altered the world's social, economic, and intellectual landscapes. The Information Age has transformed leisure, employment, business, and financial systems, and modified historical approaches to organizing and executing political and social action. A concomitant revolution in communications has blurred the boundaries that historically demarcated work from play; for many people today, including academics, employment and leisure are remote and wireless.
So, how has escalating scientific and technological change affected the health and quality of life of people in marginalized communities? How is evolving and sometimes conflicting knowledge put into practice, particularly by people living with chronic illness or at risk of blood-borne viral infections? What harm reduction practices and treatment strategies are currently recommended or could be recommended, and why? Reflecting on these questions, the organizers of the 11th HIV, Hepatitis and Related Diseases conference, which was hosted by Australia's National Centre in HIV Social Research during its twentieth anniversary, devised the theme evolving knowledge and practice to promote analysis of progress in scientific knowledge, biomedical technologies, and research methods. The conference theme invited presenters to explore how communities at risk of HIV and/or hepatitis C make sense of and negotiate developments in the production of knowledge and technologies. We were interested in highlighting the potential impact of such developments on people's everyday sexual, drug use, and health management practices. We also invited consideration of how researchers, educators, policy makers, health professionals, and lawyers respond to new scientific advances, innovative theory, and improved models of best practice in the prevention of blood-borne viruses like HIV and viral hepatitis, and sexually transmissible infections. The research articles selected for this special issue of Contemporary Drug Problems are drawn largely from those presentations at the conference that explored contemporary understandings of injecting drug use, hepatitis C prevention, and treatment. Two extra articles were commissioned in order to cover a range of methodological, theoretical, and empirical topics.
Each year in Australia there are approximately 10,000 new hepatitis C infections with around 90% of these occurring among people who inject drugs (MACASHH, 2006). Hepatitis C prevention in 2010 remains a significant challenge given the population prevalence of the virus, the natural history of infection, a legislative framework of drug prohibition, and the not uncommon phenomenon of hepatitis C-related stigma and discrimination. Similarly, despite improvements over the past decade in the efficacy of treatment to suppress infection, strategies aimed at increasing hepatitis C treatment uptake have had little impact. Today in Australia, our health system is confronting an epidemic of hepatitis C-related liver disease.
This collection of articles highlights the multidisciplinary nature of social research on hepatitis C and illicit drug use, with contributions from anthropology, sociology, epidemiology, and social psychology. The guest editorial team aimed to showcase rigorous and innovative research that we believe represents an evolution in knowledge and practice in these areas. For example, the article by Paquette, Bryant, and De Wit is unique in this issue because it advances our understanding of the research processes that allow us to study hepatitis C and injecting drug use in Australia. The authors show how the relatively new method of respondent-driven sampling can be used successfully in an Australian setting to recruit people who inject drugs (PWID); however, as they argue, the capacity of respondent-driven sampling to produce population estimates remains unclear. …