Hepatitis C and injecting drug use: The realities of stigmatisation and discrimination

Abstract

Objective To examine the extent of discrimination and stigmatisation related to hepatitis C virus (HCV) infection, as experienced by injecting drug users in Sydney, Australia. Design Data were collected through a self-administered questionnaire from injecting drug users (IDUs). Questions included basic demographics, injecting and sexual history, HCV knowledge, risk practices, self-reported HCV diagnosis, and experiences of discrimination and o stigmatisation, as well as harm reduction services provided by needle and syringe programmes (NSPs). Both qualitative and quantitative data were collected from IDUs. Setting Questionnaires were distributed to clients of NSPs in the Sydney metropolitan area. Method Ten NSPs and one methadone clinic were selected. Questionnaires were distributed to all of these outlets and a total of 274 persons were recruited. The staff at the selected sites asked clients to fill out the questionnaire while distributing injecting equipment. Results Most HCV related discrimination against drug users was reported in health care settings. Fifty-two per cent of the participants experienced this as a result of being HCV positive. In addition, more than half of the sample (65 per cent) reported that such discrimination was actually as a result of being a drug user. Females were more likely than males to experience discrimination because of their HCV status. Conclusion The level of discrimination and stigmatisation was widespread in health care settings, resulting from the stereotyping of at UNIV OF MICHIGAN on June 25, 2015 hej.sagepub.com Downloaded from 257 IDUs. The barriers to IDUs accessing health services need to be identified and removed. Implementation of an awareness campaign among health professionals would be a feasible way to address this issue.

Hepatitis C

“…Furthermore, women experienced stigma more often than men, which has been reported by other researchers (Habib & Adorjany, 2003;Zickmund et al, 2003). Other qualitative researchers described women as "acknowledging" their hepatitis C and actively talking about it, whereas men dismissed it (Temple-Smith, Gifford, & Stoove, 2004).…”

“…The response to HCV-related stigma, and specifically disclosure-related stigma, in this study and in others is the dangerous practice by HCV-positive persons of decreasing disclosure practices (Butt et al, 2008;Crockett & Gifford, 2004;Cromier, 2005;Grundy & Beeching, 2004;Habib & Adorjany, 2003;Moore et al, 2008;Temple-Smith et al, 2006). The withdrawal effect stigma has on the HCV-positive individuals is obvious, but the larger effect might not be so obvious.…”

“…Researchers have also shown that stigma affects HCVpositive individuals' disclosure practices negatively (Crockett & Gifford, 2004;Cromier, 2005;Grundy & Beeching, 2004;Habib & Adorjany, 2003;Moore, Hawley, & Bradley, 2008;Temple-Smith, Jenkinson, Lavery, Gifford, & Morgan, 2006). Researchers have defined disclosure practices as encompassing "both an individual's willingness and the actual discussion of having hepatitis C" (Moore et al, 2008, p. 347).…”

Living with Hepatitis C Virus: A Systematic Review and Narrative Synthesis of Qualitative Literature

“…Many patients believed that they were treated insensitively [40, 47, 53, 60], adequate time was not spent with them [64], confusing medical terms were used [64], and healthcare practitioners refused them treatment [47, 65]. …”

Prevention of HIV/AIDS among injecting drug users in Russia: Opportunities and barriers to scaling-up of harm reduction programmes

“…The denial of HIV/AIDS and behavioural risks contributing to the epidemic are not uncommon in many countries [82,83]. In the Soviet Union and postcommunist Russia this denial has been reinforced by the political discourse of the Soviet ideology aimed at bringing up "ideal" men and women.…”