Hepatitis C is often impacted by significant social stigma, affecting marginalized groups including people with lived experience of drug use and imprisonment, as well as Indigenous communities. Stigma arises when negative attitudes, beliefs and stereotypes are held by individuals or society towards a particular group. This leads to discrimination, marginalization, as well as negative social and health outcomes for stigmatized groups or individuals.
People who use drugs and hepatitis C
People who use drugs, particularly through injection, are at a higher risk of contracting hepatitis C through sharing needles and other drug use equipment. However, the stigma associated with drug use creates barriers to testing, treatment and support for those living with or at higher risk for hepatitis C. Many individuals are reluctant to disclose their drug use or hepatitis C status to healthcare providers for fear of judgment or discrimination, which makes it difficult to access care and further compounds the negative health impacts of the virus.
Additionally, the stigma associated with substance use prevents individuals from accessing harm reduction services that dramatically reduce the risk of hepatitis C transmission, such as needle exchange programs. When individuals feel shame or fear judgment about their drug use, they are less likely to seek out resources that could help prevent the transmission of hepatitis C.
Canadian prisoners and hepatitis C
Hepatitis C is a serious health concern in the Canadian prison system, with antibody prevalence among prisoners up to 40 times higher than the national average. However, the stigma associated with imprisonment creates greater barriers to diagnosis, treatment and support for those living with hepatitis C.
Many prisoners avoid testing or treatment due to fear of discrimination from cellmates or correctional staff because of the stigma associated with the virus. Additionally, access to medical care in prisons is limited and treatment options for hepatitis C may not be readily available for those who need it most.
Indigenous communities and hepatitis C
Indigenous communities are disproportionately affected by hepatitis C. This overrepresentation is due to a range of social, economic and environmental factors, including the impact of colonialism and residential schools, socioeconomic status and inadequate access to healthcare services.
Many Indigenous people living with hepatitis C experience discrimination and marginalization in areas such as healthcare, employment and housing as a result of the stigma associated with the condition, as well as historic and ongoing colonialism and racism. This contributes to cycles of poverty and marginalization, which further aggravates the impact of the virus on individuals and communities.
Impact of stigma on health and well-being
The stigma associated with hepatitis C has a significant impact on the physical and mental health of individuals. Shame, fear and isolation due to the stigma resulting from a hepatitis C diagnosis intensifies the negative health impacts of the virus, which include liver damage, liver failure, cirrhosis and liver cancer. Additionally, individuals may experience mental health challenges such as depression, anxiety and post-traumatic stress disorder due to the stigma and discrimination they encounter. Unsurprisingly, the impact of stigma can also affect employment and housing which can further perpetuate the marginalization of communities most affected by hepatitis C.
How do we address stigma?
Addressing hepatitis C stigma requires a multi-faceted approach that includes increased education and awareness, access to harm reduction services and medical care, as well as support for people living with hepatitis C and the eradication of discrimination. By addressing the stigma associated with hepatitis C, we can improve the health and well-being of affected communities.
Daphne Rose is a passionate criminal justice student completing her winter placement with PASAN, a community-based prison health and harm reduction organization in Toronto. Under the guidance of the provincial hepatitis C coordinator, she is learning about the health challenges faced by prisoners, particularly those related to hepatitis C. Additionally, Daphne serves as a support worker in a community residential facility, where she provides reintegration planning and support for federal prisoners. Daphne’s commitment to prisoner rights is highlighted through her personal and professional work. Her lived experiences have also given her a unique perspective on the challenges faced by those affected by the criminal justice system.
- Canada, P. H. A. of. (2022, August 31). Government of Canada. People living with Hepatitis C (HCV) in Canada – Canada.ca. Retrieved February 14, 2023, from https://www.canada.ca/en/public-health/services/publications/diseases-conditions/infographic-people-living-with-hepatitis-c.html
- The epidemiology of hepatitis C in Canada. CATIE. (2022, August 3). Retrieved February 13, 2023, from https://www.catie.ca/the-epidemiology-of-hepatitis-c-in-canada-0
- Stigma and Discrimination. Hepatitis Education Canada. (2018, April 17). Retrieved February 14, 2023, from https://hepatitiseducation.med.ubc.ca/providers/stigma-discrimination/