Finger on the Pulse
The UFO Plan meets young IV drug users where they are
by Larry Buhl
Hepatitis prevention and treatment efforts depend on outreach. For IV drug users (IDUs) under the age of thirty, there’s an issue of trust: They don’t mix well with other at-risk groups and they’re wary of well-meaning experts who want to inform them of the risk of contracting the hepatitis C virus (HCV) and other blood-borne infections.
But there is a new model program that aims to get young, at-risk adults to test for these diseases by meeting them where they are. The UFO Model, which stands for You Find Out, is based on programs and research on young adults at risk of HCV that have been running in San Francisco for more than fifteen years. Last year UFO won a grant from the CDC to create a replication package for other agencies and communities across the U.S. This package, called UFO Presents, is being pilot-tested around the U.S.
Kimberly Page, a professor of epidemiology and biostatistics at University of California, San Francisco, and principal investigator on the UFO research project, spoke with me about UFO Presents and how clinics and services might use it to boost their success in reaching, educating, testing and treating younger IDUs in any community.
Larry Buhl: First, what makes the UFO Model unique?
Kimberly Page: UFO Presents, also called the UFO Model, focuses specifically on the needs and interests of young adults. After only one year of injecting, twenty percent of young adults will become infected with hep C. After five years, almost half will be hep C-positive. Many harm reduction-based agencies have experience with older IDUs, but are being challenged by an influx of young adult IDUs whose service and preventive needs differ from their older counterparts.
Many agencies are already doing this type of work: outreach, referrals, syringe access. UFO Presents helps reframe those services by adding knowledge of hepatitis and understanding of the issues and needs of young adult injectors. It incorporates peer-based outreach, to meet these young people where they are and make it open and non-judgmental. Outreach workers need to have their finger on the pulse of at-risk young people to understand their concerns and attitudes.
What are the steps in getting this implemented nationwide?
We’re working to let folks know that there’s a science-based program they can use and adapt fairly easily in their communities. Right now people can go to our Web site at www.ufomodel.org, and download the replication manual.
Longer term, we are doing needs assessments to see how UFO Presents can be adapted to various populations at high risk for hep C, such as young adults who have not yet started injecting and young gay men who inject.
What are some of the most difficult problems in getting young IDUs tested and treated?
The most difficult problems are structural. First, there is the appalling lack of funding for hep C programs, research, and tracking. There are only five states that report new hep C cases to the CDC, which makes it difficult to know the scope and direction of the hepatitis epidemic in the U.S.
Hep C testing and test counselor training are rare at agencies and local health departments due to lack of funding. Education is a problem because most agencies are funded through HIV money and knowledge of hepatitis A, B, and C transmission is lacking and many hep C materials available are out of date or inaccurate. Outreach is a problem, too, because young adults are a new population for many agencies. That means conducting effective outreach requires different approaches.
Larry Buhl is a freelance journalist and screenwriter living in Los Angeles.