This thesis documents my research on the epidemiology of Human Immunodeficiency Virus (HIV), hepatitis C virus (HCV) and other transmissible infections among 'at risk' young people, injecting drug users and sex workers in inner Sydney, and how this contributed to the early understanding of these infections in these potentially vulnerable populations in Australia. It also demonstrates how this work informed the development of innovative health service models in Sydney??s Kings Cross, including the Kirketon Road Centre (KRC) and the Sydney Medically Supervised Injecting Centre (MSIC), to address the public health risks affecting these populations over time. Sub-themes include the establishment of sentinel surveillance systems at KRC to monitor HIV and HCV prevalence and incidence as well as trends in drug use in these populations, considered to be key drivers of these epidemics in Australia. Another sub-theme is the clinical trials of pharmacotherapies for both opioid and psychostimulant dependence and the development of the dual treatment approach to HIV (and later HCV) and drug dependence that built upon this. KRC has been an exemplar of this approach, which has been shown to enhance treatment adherence among people who inject drugs ?? necessary to achieve treatment outcomes comparable to other affected populations. In more recent years my research has also included a focus on the epidemiology, physiology and treatment of opioid overdose and other injecting-related harms among IDUs. Underlying my work over the past 20 years has been my commitment to the social justice belief that health is a basic human right and that these socially marginalised populations should have equitable access to high quality evidence-based health care.
| Identifer | oai:union.ndltd.org:ADTP/272574 |
| Date | January 2009 |
| Creators | van Beek, Ingrid, Public Health & Community Medicine, Faculty of Medicine, UNSW |
| Publisher | Awarded By:University of New South Wales. Public Health & Community Medicine |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | http://unsworks.unsw.edu.au/copyright, http://unsworks.unsw.edu.au/copyright |
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