People with and at risk of hepatitis C experience discrimination in a range of settings—predominantly in the healthcare system, but also in employment and social networks.44, 45, 46, 47 Discrimination is a barrier to accessing information, prevention, support, testing, treatment and care.48, 49 Members of the hepatitis C priority populations may experience other types of discrimination which are then exacerbated by discrimination based on their actual or perceived hepatitis C status. The two previous national hepatitis C strategies recognised the impacts of stigma and discrimination. This third strategy prioritises addressing these issues among those most affected by hepatitis C.
In 1992 the Intergovernmental Committee on AIDS’ Legal Working Group recommended promoting the need for policy and legislative reform to support effective responses to BBVs among people who inject drugs and other priority groups. While reform has occurred in line with these recommendations in some areas, including men who have sex with men and sex workers, no progress has been made with people who inject drugs.
Harmonisation between drug control laws and public health policy would create a better social and legal environment for enhanced application of established hepatitis C prevention strategies among
people who inject drugs.
Priority actions around stigma and discrimination
- Develop and implement a national hepatitis C public education campaign to dispel the myths and misconceptions around hepatitis C and reduce discriminatory attitudes and behaviour in the general community, specifically within healthcare settings.
- Create supportive and enabling environments, promote the health and human rights of those living with or at risk of hepatitis C and support access to hepatitis C prevention, treatment and care services.
- Include information on mechanisms for reporting discriminatory practices in healthcare and other settings in resources developed for people living with hepatitis C and address stigma and discrimination in healthcare worker training.
- Identify and work to address legal barriers to evidence-based prevention strategies across jurisdictions.
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44 Anti-Discrimination Board of New South Wales (ADBNSW), 2001, C-Change— Report of the enquiry into hepatitis C related discrimination. Sydney: Anti-Discrimination Board of New South Wales.
45 Treloar C & Cao W 2005, ‘Access to harm reduction services and "hidde" injectors: Barriers to NSP use in a high drug use area of Sydney, New South Wales’, International Journal of Drug Policy 16: pp. 308–15.
46 Hopwood M, Treloar C & Bryant J, 2006, ‘Hepatitis C and injecting-related discrimination within healthcare in New South Wales, Australia’, Drugs: Education, Prevention and Policy 13: pp. 61–75.
47 Treloar CJ & Hopwood MN 2004, ‘Infection control in the context of hepatitis C disclosure: Implications for education of healthcare professionals’, Education for Health, 17(2), pp. 183–191.
48 Hepatitis Australia 2009, Do you C what I C?, report on the information and support needs of people living with hepatitis C in Australia. Canberra: Hepatitis Australia.
49 Ahern J & Stuber J et al. 2007, ‘Stigma, discrimination and the health of illicit drug users’, Drug and Alcohol Dependence, vol. 88: pp. 188–196.