28 July marked World Hepatitis Day, and this year’s theme – “Hepatitis: Let’s Break It Down” – calls for urgent action to dismantle the financial, social and systemic barriers, including stigma, that stand in the way of eliminating hepatitis and preventing liver cancer.
For people experiencing homelessness, these barriers are often at their highest. Chronic hepatitis B and C silently cause liver damage and cancer, despite being preventable, treatable and, in the case of Hepatitis C, curable. But stigma, lack of access to healthcare, and competing survival priorities mean many go undiagnosed and untreated. Breaking down these barriers is critical if the UK is to meet its goal of eliminating Hep C as a public health threat by 2030.
Hepatitis C (Hep C) is a blood-borne virus that primarily affects the liver. If left untreated, it can cause serious complications such as liver damage, cirrhosis and even liver cancer. The good news is that treatment is now simple, highly effective and usually involves a short course of tablets with minimal side effects. With the right support, Hep C is both preventable and curable.
Why is Hep C a Risk for People Experiencing Homelessness?
Research shows that people experiencing homelessness are significantly more likely to be living with untreated Hep C than the general population. Several factors contribute to this increased risk:
- Injecting drug use: Sharing needles and injecting equipment is one of the most common routes of transmission.
- Barriers to healthcare: People without stable housing often face challenges accessing GP services, testing, and treatment.
- Multiple disadvantage: Co-occurring issues such as mental health struggles, stigma, and poverty make it harder to prioritise health needs.
This is exactly why this year’s World Hepatitis Day theme is so relevant. For people experiencing homelessness, stigma around substance use and hepatitis can act as a powerful barrier, stopping people from seeking help or feeling worthy of treatment. Breaking down that stigma and integrating accessible testing and treatment into homelessness and drug services is essential to eliminating Hep C and preventing liver cancer.
A National Commitment to Elimination
The UK Government has pledged to eliminate Hep C as a public health threat by 2030. The “Hep C U Later” campaign is driving this ambition forward, focusing on testing, early diagnosis, and removing barriers to treatment. Locally, partnerships across Nottingham have played a vital role in contributing to this national goal.
Micro-Elimination Success in Nottingham
Framework is proud to be the lead partner of Nottingham Recovery Network (NRN), which has achieved a major milestone: Hepatitis C has been micro-eliminated across all of NRN’s drug treatment services in Nottingham City.
Micro-elimination means that within a specific population – in this case, every person accessing NRN services – everyone has been offered testing and, where needed, completed treatment. As a result, there are currently no individuals living with untreated Hep C in NRN’s network.
This achievement was only possible through five years of dedicated partnership work. The Health Shop, a key service offering harm reduction and needle exchange in Nottingham, played a leading role. The team provides vital health promotion and practical support to people who use drugs, those experiencing homelessness, individuals from the LGBTQ+ community and others facing health inequalities.
To mark this success, the Health Shop hosted a celebration event at the Wellbeing Hub, bringing together colleagues from across services to recognise the impact of collaborative work in tackling Hep C. We are hugely grateful to all colleagues involved in this landmark success for our city.
Continuing the Work
Although micro-elimination has been achieved within NRN’s services, the work doesn’t stop here. People experiencing homelessness remain at increased risk of infection and reinfection, which is why ongoing outreach, education, and harm reduction are vital.
Lou Wilkins, Team Leader at the Health Shop, said:
“We are so thrilled to achieve this micro-elimination. The Health Shop team want to express how grateful they are to everyone who has been involved. Whether it’s talking about Hepatitis C, supporting with testing and encouraging service users to take treatment – everything makes a difference. It’s all about our service users – finding people who didn’t know they were living with Hepatitis C, and that is why the work continues!”
Get Support
If you are at risk of Hepatitis C, getting tested is quick and easy – and treatment is life-changing. Framework and the Health Shop can help you access free, confidential support without judgement.
Find out more about Framework’s support services via our website, or call us on 0115 841 7711.
The Health Shop can be contacted at 07585 991542 or email healthshop@nottshc.nhs.uk.
For support with drug and alcohol use, visit www.nottinghamrecoverynetwork.com or call 0800 066 5362.