The impact of hepatitis C on women: Learnings from the CanHepC 2025 Symposium
In February, CATIE attended the 14th Canadian Symposium on Hepatitis C, which was hosted by the Canadian Network for Hepatitis C (CanHepC) as part of the Canadian Liver Meeting. This national conference brought experts from across the country to Quebec City, where they showcased the latest in hepatitis C research.
The symposium highlighted diverse perspectives on the theme “Hepatitis C in Women” from clinicians, researchers and people with lived and living experience of hepatitis C and substance use. During the event, CATIE asked presenters and attendees to share key takeaways from the conference about this important topic.
Watch the short video and read the summary below to learn more about the impact of hepatitis C on women.
Women as an emerging and underserved hepatitis C priority population
Women are an emerging priority population increasingly at risk for hepatitis C. While hepatitis C has historically been more common in men, women are now catching up—and even surpassing men—when it comes to new infections. In Canada, the rising number of hepatitis C infections in women is influenced by trends and patterns in drug use. For example, some women may exchange sexual services for drugs, share injection equipment with multiple partners, or have limited control over drug safety due to power imbalances, like being “second on the needle” when sharing syringes. This increased transmission risk is driven by systemic and structural barriers, including gender-based violence, stigma and discrimination, which hinder access to care and support. Barriers to care are often compounded by intersecting aspects of women’s identities, many of which are reflected by the priority populations that are most impacted by hepatitis C, including people who use drugs, Indigenous people and people with prison experience.
Opportunities for engagement in the care cascade
Presenters at the Canadian Symposium on Hepatitis C explained that women, particularly those who use substances, are starting treatment at lower rates than men due to lack of attention to sex and gender across health services, which contributes to disparities in treatment initiation. Many existing hepatitis C prevention and care services are not designed with women’s unique needs in mind, so traditional methods of linking people to care often fail to reach them. As a result, women are being overlooked in the hepatitis C response.
Additionally, more people of reproductive age, including women who are pregnant and/or breastfeeding, are acquiring hepatitis C. Perinatal care may be an ideal window to offer testing and treatment for hepatitis C, since women are already engaged in routine health services. Early diagnosis and management are crucial to reduce the risk of transmitting hepatitis C to an infant and improve health outcomes for both the mother and child.
While there is a great opportunity to engage pregnant women in hepatitis C care, broader strategies including gender-specific and gender-responsive approaches, are also needed to reach women who may not access health services due to pregnancy. These may include offering women-only harm reduction services, integrating gender-specific peer support in health services and embedding hepatitis C care in interventions addressing the intersecting needs of women (i.e. housing, childcare, employment).
The importance of gender-responsive strategies
Promoting equitable access to hepatitis C prevention, testing and treatment requires strategies that recognize the unique barriers women face, while centring their diverse needs and identities. Presenters noted the transformative impact of low-barrier, tailored programs for women. This includes adopting a ‘no wrong door’ approach—a compassionate, dignity-focused model that meets people where they are, even if they’re not yet ready to start treatment.
Because Indigenous people, especially Indigenous women, are disproportionately impacted by hepatitis C, a culturally grounded, gender-responsive approach was also highlighted as essential to ensure that no one is left behind in the hepatitis C response. This involves integrating Indigenous wellness practices into healthcare during patient visits, such as traditional medicine and the work of Elders, as well as using frameworks like the Medicine Wheel.
Presenters also noted a lack of services geared towards transgender and gender diverse people, who may not identify as women and are often overlooked in research and practice. They face many of the same systemic barriers that impact cisgender women, in addition to many others unique to them. Presenters emphasized that gender-responsive strategies must also be tailored to include trans and gender diverse people to ensure that care is truly inclusive.
In order to ensure equitable access to care, it is essential to adapt prevention, testing and treatment strategies to women’s specific needs while considering the intersecting factors that shape their experiences. By recognizing women as an emerging priority group and providing culturally grounded and stigma-free services, we can address the unique risks and barriers women face and help close the gap in hepatitis C outcomes.
Madison Kennedy is CATIE’s hepatitis C knowledge specialist.