Experiences of diagnosis, care and treatment among Aboriginal people living with hepatitis C

Abstract

Objective: Aboriginal Australians are disproportionately affected by hepatitis C (HCV). There are a range of barriers to HCV care, often beginning with poor diagnosis experiences. Little research exists on the experiences of Aboriginal Australians living with HCV. This study aimed to describe their patterns of HCV care and treatment with specific emphasis on the impact of their being informed of their diagnosis in a culturally sensitive manner. Methods:A total of 203 Aboriginal people living with HCV were recruited to complete a survey assessing experiences of HCV testing and care, HCV knowledge, lifestyle changes after diagnosis, perceived stigma and discrimination.Results: Of the sample, 58% were male and 96% identified as Aboriginal, with a mean age of 28 years. Correlation analysis revealed that satisfaction with the cultural appropriateness of the diagnosis was associated with: being offered pre-and post-test counselling; satisfaction with HCV care; decreased feelings of HCV-related stigma; lower scores on the medical mistrust scale; and greater intentions to access HCV treatment. Conclusions:These findings confirm the importance of providing a HCV diagnosis in a culturally appropriate way for Aboriginal people.Implications: Satisfaction with HCV diagnosis appears essential in establishing patterns of greater engagement with HCV care and treatment for this group.

Disparities in uptake of direct‐acting antiviral therapy for hepatitis C among people who inject drugs in a Canadian setting

“…However, in a setting with public coverage of DAAs for eligible patients as ours, other factors may better explain differences in treatment access between white and non‐white participants. Among these, a growing body of evidence has highlighted how the dual stigma that PWID of Indigenous ancestry face when trying to access healthcare can result in delaying or forgoing needed care altogether . Collectively, these findings underscore the need for safe and culturally‐appropriate health services to optimize engagement in HCV care and improve health outcomes among Indigenous people.…”

CDC Recommendations for Hepatitis C Screening Among Adults — United States, 2020

“…No study compared harms systematically using comparison groups associated with different screening approaches. Harms informed by the alladult review included physical harms of screening (two studies) (48,49); anxiety/stress related to testing or waiting for results (five studies) (49-53); cost (one study) (54); anxiety related to receiving positive results (one study) (55); interpersonal outcomes (e.g., problems related to family, friends from learning HCV infection status) (five studies) (51,(55)(56)(57)(58); attitudes toward persons with hepatitis C, including stigma (11 studies) (49,55,(57)(58)(59)(60)(61)(62)(63)(64)(65); time for screening (two studies) (49,66); and false-positive results, including among left ventricular assist device patients, possibly precluding heart transplantation (six studies) (67)(68)(69)(70)(71)(72). Harms informed by the pregnancy review included physical harms of screening (one study) (73), anxiety (five studies) (74)(75)(76)(77)(78), stigma (one study) (77), psychological issues (two studies) (73,79), fears related to sexual relationships (one study) (80), legal ramifications and potential loss of infant custody (one study) (81), decreased quality of life (one study) (82), social repercussions (one study)…”

Environmental factors affecting self‐management of chronic hepatitis B from the patients’ perspective

“…Studies of patients with liver disease worldwide have suggested that patients' explanations of symptoms (such as fatigue and tiredness) may be influenced by folk health beliefs, which affect the health behaviours and management of the disease, including adopting new lifestyles or alternative/traditional treatments (Brener et al, 2016 (Fang & Stewart, 2018), remedial or healing herbs (Fang & Stewart, 2018;Giles-Vernick et al, 2016). In the patients' experience, these treatments are often used as alternative treatments instead of usual medical treatment (Fang & Stewart, 2018;Lee et al, 2017;Owiti et al, 2015).…”

“…Studies of patients with liver disease worldwide have suggested that patients’ explanations of symptoms (such as fatigue and tiredness) may be influenced by folk health beliefs, which affect the health behaviours and management of the disease, including adopting new lifestyles or alternative/traditional treatments (Brener et al, ; Burnham et al, ; Owiti, Greenhalgh, Sweeney, Foster, & Bhui, ). Traditional treatments are often related to cultural beliefs, including spiritual healing (Fang & Stewart, ), remedial or healing herbs (Fang & Stewart, ; Giles‐Vernick et al, ).…”