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There is considerable interest in determining the impact that increased uptake of treatment for hepatitis C virus (HCV) infection will have on the burden of HCV among people who inject drugs (PWID). An understanding of the size of the population of PWID, rates of injecting cessation and HCV prevalence and incidence within the PWID population is essential for such exercises. However, these parameters are often uncertain. In this paper we review methods for estimating the size of the population of PWID and related parameters, taking into account the uncertainty that exists around data on the natural history of injecting drug use; consider issues in the estimation of HCV prevalence among PWID; and consider the importance of opioid substitution therapy and prisons as settings for the prevention and treatment of HCV infection among PWID. These latter two points are illustrated through examples of ongoing work in England, Scotland and Australia. We conclude that an improved understanding of the size of PWID populations, including current and former PWID and parameters related to injecting drug use and settings where PWID may be reached, is necessary to inform HCV prevention and treatment strategies. [ABSTRACT FROM AUTHOR]

Abstract: This study examines two regional youth welfare agencies in different parts of the world that have independently from each other begun to redevelop their organisations within a community governance framework. This means that they are involved in an arena of public decision making about local resources that extends beyond local state services to embrace those activities that involve either the provision of public services as part of the community, or the representation of community interests to the broader policy community. The two agencies used in this study are Brophy Family and Youth Services in Warrnambool, Australia, that services southwest Victoria and Aberdeen Foyer in the regional city of Aberdeen, Scotland that services the rural hinterland. While these agencies are pursuing the same path towards a community governance approach they have adopted different strategies to achieve their aims. Using these two agencies as exemplars this paper outlines a conceptual model that helps to provide an understanding of an emerging community governance framework in the welfare sector. [Copyright &y& Elsevier]