Blood Borne Infections (BBI)
  1. HIV
  2. HCV
  3. MRSA, cellulitis, endocarditis

People who use injection and inhalation drugs have a different relationship to, including risk potential, with infections that travel in blood. Particularly through injection practice, the bloodstream has increased contact with pathogens (germs), as it doesn’t operate as a closed, bounded system in ways that conventional health information expects as a default. 

Long term users may have personal experiences with managing or living with blood-borne infections. It is absolutely imperative that when talking about BBIs, we must not assume that any or all people in the room are negative (HIV/HEPC/oBBI). Stigma about BBIs can make it challenging for people living with an infection to speak honestly about that experience. These conversations must unfold in ways that recognize the unique insight and value of personal lived experiences of peers, including HIV +and/or HEPC + individuals. 


1. Blood Borne Infections: HIV 

Potential Learning Outcomes
  • Up to date information about testing, transmission, treatment.
  • Reduced stigma and internalized shame as a result of open conversation and accurate information. 

Discussion Topics
What does HIV testing look like these days?
  • Rapid test, NATE test, traditional blood draw, GetCheckedOnline, Clinic, Outreach Nurse, Doctor

What is a window period?
  • The period in time between when HIV has gone into a body, and when it will be visible to a test. Variable between tests

What is U=U? How does this change HIV prevention, sexual consent, and stigma?
What is PrEP? Who can get it? 
How can we take care of our immune system if it is compromised?
  • Sleep, healthy eating, managed substance use including breaks and substitutions, taking medications


Suggested Resources
CATIE.ca Ordering Centre for access to all sorts of web and print resources
http://orders.catie.ca/

HIV + Hep C Survival in Used Syringes explained:
https://www.youtube.com/watch?v=e5xgKaX8z78&list=PL40D8E249F1025C7E&index=3


2. Blood Borne Infections: HCV

Potential Learning Outcomes
  • Up to date information about testing, transmission, treatment.
  • Reduced stigma and internalized shame as a result of open conversation and accurate information. 

Discussion Topics
How do HEP C Tests work?
  • Antibody test, followed by RNA test- determining genotype

Hep C treatment has advanced a lot in the past few years, become more available and with fewer drastic side effects. What are the pros and cons of undergoing treatment for Hep C?
  • Time to “be in treatment”
  • Supports needed
  • Overall wellness
  • Fatigue
  • Digestive Complications

How can we take good care of our liver if it is compromised?
  • Staying hydrated
  • Reduced-fat diets
  • Abstaining/Reduced “junk food” diets
  • Abstaining/Reduced alcohol
  • Complementary therapies

What harm reduction strategies can we use to prevent the spread of Hep C?
  • New gear every time
  • Colour coded straws, rigs, mouthpieces
  • Clean shooting gallery area
  • Using at an OPS

What are the similarities and differences between HIV + HepC transmission?
  • HCV is much more transmittable than HIV through needle injection. HIV, however, can also be transmitted through blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk; whereas, HCV is only transmitted through blood.

How long can HCV live outside the body?
  • Recent research shows that HCV can live outside of the body on surfaces (such as needles) for at least 16 hours and up to 4 days; however, studies show that many factors, such as the size of the needle/syringe and temperature can influence the outcome.

What are the “Universal Precautions” and why do we use them?
  • HCV and HIV can both remain active in dried blood for a short time; therefore precautions should be taken when dealing with blood spills and dried blood. Precautions include wearing gloves and using 1 part bleach to 10 parts water to clean area.

Suggested Resources
CATIE.ca Ordering Centre for access to all sorts of web and print resources
http://orders.catie.ca/

FAQ on HEP C: https://www.cdc.gov/hepatitis/hcv/cfaq.htm 


​3. Other Blood-Borne Infections: MRSA, Cellulitis, Endocarditis

​Potential Learning Outcomes
  • Bacterial infections that affect the bloodstream appear more likely if the bloodstream has increased interaction with the outside world (as is the case with frequent injections). Understanding the basics about each of these infections can help prevent, identify and connect to the treatment of potential infections.
  • Reduced stigma and internalized shame as a result of open conversation and accurate information. 
  • Reduced infection rates.
  • Higher likelihood to seek out care or pursue treatment of infections

Discussion Topics
What is MRSA?
A staph infection that is resistant to standard antibiotics.
https://www.youtube.com/watch?v=LYjj91_29aw

What is cellulitis?
https://www.youtube.com/watch?v=YSik5lUmBGE

What is endocarditis?
  • Staphylococcal endocarditis is an infection of the heart valves and inner lining of the heart chambers
  • It is caused when bacteria or fungi enter the bloodstream from an injury or skin disorder, taking bacteria that lives on the skin and putting it into the bloodstream. This then travels to the heart and causes inflammation and damage.
  • Depending on the strength of the bacteria the damage to the heart could either be swift (acute endocarditis) or plodding (subacute)

What are harm reduction strategies we can use to prevent the spread of these infections?
  • New gear every time
  • Colour coded straws, rigs, mouthpieces. 
  • Clean shooting gallery area
  • Using at OPS

Suggested Resources
CATIE.ca Ordering Centre for access to all sorts of web and print resources
http://orders.catie.ca/

Endocarditis Presentation from AVI (Content in Speaker Notes): https://docs.google.com/presentation/d/1FRud4014nRvQXCzLYTLmTPy2f1CfsZ4Kt6wlGthaEIU/edit?usp=sharing
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