Protecting the Rights of Health Care Students Living With Hepatitis B Under the Americans With Disabilities Act

Moraras, Kate; Block, Joan M.; Shiroma, Nadine; Cannizzo, Alexa; Cohen, Chari

doi:10.1177/0033354920921252

Cited by 10 publications

(11 citation statements)

References 10 publications

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“…The new data from this study suggest that a functional cure would alleviate this fear and anxiety associated with the risk of transmission to others and potential complications including cirrhosis and reduced risk of liver cancer, which in turn would improve overall quality of life. Additionally, stigma and discrimination among those with HBV infection are common worldwide, including in the United States 17‐22 . HBV‐related stigma can lead to social and emotional isolation, and HBV‐related discrimination can limit employment and educational opportunities.…”

Section: Discussionmentioning

confidence: 99%

Cure everyone and vaccinate the rest: The patient perspective on future hepatitis B treatment

Freeland

Racho

Kamischke

et al. 2021

Journal of Viral Hepatitis

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Those living with chronic hepatitis B virus (HBV) require years, if not decades, of regular monitoring to prevent liver complications from occurring. An estimated 292 million people were living with chronic HBV globally in 2018 with approximately 2.4 million of those residing within the United States (US). This study is one of the first of its kind that aims to explore the treatment preferences for those living with chronic HBV through qualitative interviews. Participant data were collected by in‐depth telephone interviews using a semi‐structured discussion guide. A codebook guided the organization of data, and codes were developed by review of the literature (a priori) and through line‐by‐line reading of a subsample of queries. All data transcripts (N = 19) were independently double coded. Overarching themes identified from the data specific to the treatment modalities and implications of a functional HBV cure included the concern about side effects, treatment modality, frequency, duration, cost‐effectiveness and overall impact on their lives. Qualitative data analysis revealed the significant impact that an HBV functional cure would have on quality of life. Benefits of a cure were described as not having a finite course of treatment, improving overall vitality, and reducing the fear and anxiety associated with lifelong infection and potential development of liver cancer. Many individuals expressed the desire for a cure for HBV, stating it would be life‐changing, and a ‘miracle’. As new therapies are in development, more research should examine in detail the treatment preferences of those living with HBV.

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Section: Discussionmentioning

confidence: 99%

Cure everyone and vaccinate the rest: The patient perspective on future hepatitis B treatment

Freeland

Racho

Kamischke

et al. 2021

Journal of Viral Hepatitis

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“…10,14 Even with protections and policy in place, refusal of admission within nursing and medical schools still is reported to occur. 14 There is a need to systematically document discrimination at local, country, regional and global levels and which should include the location, the causes of discrimination, where and how it is occurring at a local level. This documentation could be used to inform policy that ensures people with hepatitis B are provided protection and equal opportunity for employment, education, travel and immigration.…”

Section: Discussionmentioning

confidence: 99%

“…13 In the U.S., discrimination is experienced by healthcare students, causing denial of school admission or enrollment, restriction of clinical training or dismissal from an academic program. 14 While hepatitis B discrimination has largely been reported anecdotally within a global context, this study aims to investigate and describe hepatitis B related discrimination, document discrimination occurring around the globe, and provide initial recommendations for addressing discrimination using key informant interviews. For the purposes of this study, discrimination is described by modifying the HIV-speci c discrimination de nitions within the United Nations, 15 and where discrimination speci c to hepatitis B is de ned as the unjust, unfair, or prejudicial treatment of a person on the grounds of their hepatitis B status.…”

Section: Introductionmentioning

confidence: 99%

The Unvirtuous Cycle of Discrimination Affecting People with Hepatitis B

Freeland

Mendola

Cheng

et al. 2021

Preprint

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Background An estimated 296 million individuals live with chronic hepatitis B worldwide, most have not been diagnosed and remain at risk of liver disease and cancer. People with hepatitis B often face discrimination that denies them employment or education opportunities, results in unfair treatment at work or in school, limits their ability to emigrate to certain countries, and in some cases prohibits them from serving in the military. Discrimination specific to hepatitis B has not been widely documented within the literature. This study aims to investigate and describe hepatitis B related discrimination, document discrimination occurring around the globe, and provide initial recommendations for addressing discrimination using key informant interviews.MethodsPurposive and snowball sampling were used to identify potential key informants for qualitative interview. Key informants identified as community health leaders, public health scientists, doctors, and researchers, many of whom were also living with hepatitis B. Using a semi-structured guide, participants were asked to describe their experience and any challenges for people living with hepatitis B including marginalization and its’ consequences. A codebook was used to guide the organization of data for analysis, and all transcripts N=17 were double coded. Results The overarching themes identified from interviews demonstrate explicit experiences with discrimination of those directly affected, the psychological responses, and the negative health outcomes associated with the unvirtuous cycle of discrimination. All key informants reported on the substantial quality of life implications and often poorer health outcomes resulting from hepatitis B discrimination. Participants also identified the significant impact of hepatitis B discrimination occurring within a range of education-based services across several countries as well as military exclusion or removal if individuals are found to have hepatitis B. ConclusionOur data demonstrate that hepatitis B discrimination has a significant impact. Discrimination can occur in a cyclic nature at various points in life from education, to seeking employment, to marriage, to restrictions on entry, travel and stay in other countries. Hepatitis B discrimination impacts mental and physical health of those experiencing it and limits overall wellbeing, quality of life, can lead to poor health outcomes and avoidance of testing and management.

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“…This information can be used to guide a discussion of law as a tool for combating HBV discrimination against students in accredited health professions programs. 12…”

Section: Mapping Studiesmentioning

confidence: 99%

“…10 A second mapping study that assessed the correspondence of CDC HIV testing guidelines and state laws found that no states had laws that would hinder compliance with CDC's 2006 revised HIV testing recommendations, but also that no state had laws enacting all relevant components for recommended HIV testing. 11 To illustrate the use of legal mapping to capture data on institutional policies, Moraras et al 12 collected data on policies related to the management of students with hepatitis B virus (HBV) infection from 83 Pennsylvania schools with accredited health professions programs. This information can be used to guide a discussion of law as a tool for combating HBV discrimination against students in accredited health professions programs.…”

Section: Mapping Studiesmentioning

confidence: 99%

Policy and Public Health

et al. 2020

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Protecting the Rights of Health Care Students Living With Hepatitis B Under the Americans With Disabilities Act

Abstract: 14S to ensure that persons living with HBV infection have the opportunity to study and pursue careers in the health professions.

Cited by 10 publications

References 10 publications

Cure everyone and vaccinate the rest: The patient perspective on future hepatitis B treatment

Cure everyone and vaccinate the rest: The patient perspective on future hepatitis B treatment

The Unvirtuous Cycle of Discrimination Affecting People with Hepatitis B

Policy and Public Health

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