Responding to a national policy need: development of a stigma indicator for bloodborne viruses and sexually transmissible infections

Broady, Timothy; Cama, Elena; Brener, Loren; Hopwood, Max; Wit, John de; Treloar, Carla

doi:10.1111/1753-6405.12809

Cited by 31 publications

(28 citation statements)

References 26 publications

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“…Using a previously developed tool for indicating stigma, participants were asked how often they had experienced IDU-related stigma in the past 12 months on a 5-point Likert scale (never, rarely, sometimes, often, always). 13 Ordinal logistic regression was performed to assess the statistical association between more frequent experiences of stigma and exposure variables. The primary exposure variable of interest was the number of different health services accessed in the previous 12 months.…”

Section: Analysis Strategymentioning

confidence: 99%

Health service utilization and experiences of stigma amongst people who inject drugs in Melbourne, Australia

Djordjevic

Ryan

Gunn

et al. 2021

Journal of Viral Hepatitis

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Whilst the testing and treatment of people who inject drugs (PWID) in Australia is a priority for local hepatitis C (HCV) elimination efforts, perceived stigma related to injecting drug use (IDU) has been identified as a major barrier for PWID engaging in health services. We used data from the EC Experience cohort study to explore associations between IDU-related perceived stigma and the number of different health services accessed by PWID in Melbourne, Australia. Data from the baseline questionnaire were used. Primary outcome was self-reported experience of stigma due to IDU (never, rarely, sometimes, often, always) in the previous 12 months. An ordinal logistic regression model assessed the association between stigma experienced and the number of different health services used (1-2, 3-4, 5-6, 7-10 different services) adjusted for recent IDU and key socio-demographics. Between September 2018 and February 2020, 281 participants were recruited from four health services. Sixty-nine per cent were male, median age was 42, 83% reported past-month IDU, 34% had never tested/ tested >12 months, 8% tested negative <12 months, 43% were HCV-positive but not treated and 16% had been treated. Those accessing 5-6 services had 2.2 times greater odds of experiencing stigma (95% CI 0.86-6.65) compared with those using <5 services and those reporting 7-10 services had 2.43 times greater odds of experiencing stigma (95% CI 0.85-6.92) compared with those accessing <7 services. In conclusion, experiences of stigma may not necessarily be a barrier for PWID to access health services, but high rates of health service use may further expose, exacerbate or exaggerate stigma amongst PWID. Further examination of how stigma may be in/ directly impact on hepatitis C treatment uptake is important and place-based interventions aimed at reducing stigma experienced by PWID may be needed.

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Section: Analysis Strategymentioning

confidence: 99%

Health service utilization and experiences of stigma amongst people who inject drugs in Melbourne, Australia

Djordjevic

Ryan

Gunn

et al. 2021

Journal of Viral Hepatitis

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“…Follow-up questionnaire Follow-up questionnaires include: demographics, HCV testing/treatment knowledge, HCV transmission risk, HCV testing and treatment history, alcohol and other use, opioid treatment, incarceration history, experience of stigma and discrimination using a validated tool, 37 health service utilisation, knowledge of peer experience with HCV care, the Health Literacy Questionnaire 38 and the Brief Resilience Scale (BRS) 39 (see table 1). For participants classified as not engaged with HCV testing or treatment at follow-up (Study Groups 1 and 2), questionnaires include items on barriers to HCV testing (Study Group 1) and HCV treatment (Study Group 2).…”

Section: Patient and Public Involvementmentioning

confidence: 99%

Exploring hepatitis C virus testing and treatment engagement over time in Melbourne, Australia: a study protocol for a longitudinal cohort study (EC-Experience Cohort study)

et al. 2022

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IntroductionThe advent of direct acting antiviral therapy for hepatitis C virus (HCV) means the elimination of HCV is possible but requires sustained effort to achieve. Between 2016 and 2019, 44% of those living with HCV were treated in Australia. However, treatment uptake has declined significantly. In Australia, people who inject drugs (PWID) are the population most at risk of HCV acquisition. Eliminating HCV in Australia will require nuanced understanding of the barriers to HCV treatment experienced by PWID and tailored interventions to address these barriers. The EC-Experience Cohort study aims to explore the barriers and enablers reported by PWID to engagement in HCV care.Methods and analysisThe EC-Experience Cohort study is a prospective cohort of PWID, established in Melbourne, Australia in 2018. Participants are assigned into three study groups: (1) those not currently engaged in HCV testing; (2) those diagnosed with HCV but not currently engaged in treatment and (3) those completed treatment. Participants complete a total of four interviews every 6 months across an 18-month study period. Predictors of experience of key outcome events along the HCV care cascade will be explored over time.Ethics and disseminationEthical approval for the EC-Experience Cohort study was obtained by the Alfred Hospital Ethics Committee in Melbourne, Australia (Project Number: HREC/16/Alfred/164). All eligible participants are assessed for capacity to consent and partake in a thorough informed consent process. Results from the EC-Experience Cohort study will be disseminated via national and international scientific and public health conferences and peer-reviewed journal publications. Data from the EC-Experience Cohort study will improve the current understanding of the barriers to HCV care for PWID and guide the tailoring of service provision for specific subgroups. Understanding the barriers and how to increase engagement in care of PWID is critical to achieve HCV elimination goals.

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“…This study is part of a broader research project measuring the experiences and expression of stigma among key priority populations in Australia affected by blood borne viruses and sexually transmissible infections (STIs) (Broady et al, 2018). The current paper reports on a survey among health and medical workers and students, which assessed attitudes towards people living with HBV, hepatitis C, HIV, STIs and people who inject drugs.…”

Section: Materials S and Me Thodsmentioning

confidence: 99%

Australian health and medical workers’ concerns around providing care to people living with hepatitis B

Cama

Brener

Broady

et al. 2021

Health Soc Care Community

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There is established literature on health workers' attitudes towards working with people living with stigmatised health conditions and behaviours, such as HIV, hepatitis C and injecting drug use. Less is known about health workers' attitudes and concerns around providing care to people living with hepatitis B virus (HBV), which is concerning as research indicates that negative attitudes may impact on the quality of care provided to these populations, with adverse health outcomes for clients. The How to cite this article: Cama E, Brener L, Broady T, Hopwood M, Treloar C. Australian health and medical workers' concerns around providing care to people living with hepatitis B.

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Responding to a national policy need: development of a stigma indicator for bloodborne viruses and sexually transmissible infections

Cited by 31 publications

References 26 publications

Health service utilization and experiences of stigma amongst people who inject drugs in Melbourne, Australia

Health service utilization and experiences of stigma amongst people who inject drugs in Melbourne, Australia

Exploring hepatitis C virus testing and treatment engagement over time in Melbourne, Australia: a study protocol for a longitudinal cohort study (EC-Experience Cohort study)

Australian health and medical workers’ concerns around providing care to people living with hepatitis B

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