Stigma as a barrier to treatment

On Monday, 15 September 2014, at the World Indigenous Peoples’ Conference on Viral Hepatitis, the Centre for Social Research in Health (CRSH) launched the results of a study examining the experiences of Aboriginal Australians living with hepatitis C (henceforth HCV) and their experiences of healthcare. A study of Aboriginal people in NSW living with hepatitis C: A report to community was conducted with 203 participants across NSW.

Professor Carla Treloar outlined the key findings of the research at yesterday’s launch, primarily the impacts of stigma and discrimination, with specific reference to the entangling nature of racism and HCV. Participants of the study described their experiences of health care workers expecting Aboriginal patients to have “these things”, referring to HCV.

Treloar explored the notion of ‘overlapping stigma’: Aboriginal Australians living with HCV can experience a combination of stigmas, such as the stigma of living with HCV, which can be linked to the stigma attributed to being  a person who injects drugs (based on assumptions regarding the mode of transmission) and additionally associated stigmas that society projects on Aboriginal people. Stigma influences patient decisions to disclose their HCV status to family and friends. Deciding not to disclose denies patients potential support networks which are vital during treatment.

The detrimental effects of stigma are evident at an individual and societal level. Treloar identified that experiences of stigma increase the burden of disease for the individual, and stigma on a population level increases health inequalities for minority groups.

Findings indicate that participants who thought that their diagnosis was delivered in a culturally appropriate manner were more likely to consider and commence treatment. These findings reinforce the need for health professionals to have culturally appropriate pre and post test discussions in order to increase rates of Aboriginal and Torres Strait Islanders receiving HCV treatment. Similarly, participants emphasised the need for health care professionals to adequately discuss HCV when diagnosis is delivered rather than numerous reports of being given pamphlets and denied an opportunity for further discussion.