Barriers to Hepatitis C Care and Treatment
Many of you may have experienced first-hand what these words mean. Whether it is because of insurance coverage issues or publicly funded provider restrictions, there are a large group of people who do not have simple access to care and treatment. We hear it every day in the work of peer navigation and support. People are denied access for a wide range of reasons.
In our work with people who are uninsured or underinsured under the US model, we are able to find help, and empower people to secure the care they need.
As we are often marginalized for our financial standing, hepatitis c status, or because we are facing financial hardship, we are fighting a huge and sometimes seemingly insurmountable battle. It is hard to stay positive in an environment where it appears that we have been discarded. Stigma around hepatitis c is not uncommon, and this alone can be a barrier that appears too difficult to overcome
Please believe me when I say we all have not left you behind.
There are things we can all do.
Unfortunately there are geographical differences in the availability of services.
Some jurisdictions have a very harsh approach to the populations at greatest need and risk, and sadly judge these populations as being less deserving. This reminds me of something I quote loosely in saying “ we can judge a society by how it treats its most vulnerable members”.
There can be social and cultural barriers to care. In some populations in the broad HCV community there can be language barriers and a diminished understanding about what many of us would take for granted. In populations of recent immigrants we have seen an apprehension to engage in care out of fear and simple mistrust of official systems such as healthcare. There is also the stigma which is more acute in some populations affected by hepatitis c.
For some people seeing a doctor is a frightening experience, regardless of any social or cultural beliefs. The fear of cost and ability to pay is another barrier. Something as basic as secure housing can be a barrier for a segment of the HCV community. Having a safe environment and support mechanisms in place is huge for this segment. Adherence to treatment protocols is crucial once engaged, and a stable environment is key.
What so many of us see as a normal and common activity can seem insurmountable for some. Mental health can be an obstacle to accessing care. Fear of being further marginalized is far too often a deterrent to seeing a doctor or healthcare provider. Some people will have well entrenched beliefs that are based on prior experience with the healthcare system or even a bad experience with a healthcare provider. Not all health care providers are sensitive to their patients needs as we know. People who use drugs as a part of their lives often are reluctant to seek medical care for many reasons, real or perceived. In places where specific services are available for this population that can include robust outreach programs, peer support and navigation, there is an improved chance of engagement and better outcomes.
One thing that is clear to me is there are many reasons why access to care and treatment is not the same for us all. Despite the differences, having reasonable access to medical and social services is key in seeing better outcomes.
HCV can be a devastating illness if not addressed in a sensitive, respectful, sensible and realistic way.
The reality for one is not necessarily a reality for us all.
In our work as peer navigators we try to remove barriers through education, support, and referring people to good services and support. The education hopefully leads to a better understanding of where and how a person can be tested and secure care and treatment. The language of HCV in itself can be overwhelming, not to mention all the other things I have mentioned. Finding services that are close by is another important piece, while building pathways to care with trust and reliable information being at the core.
Hope has always been at the center of my universe when it comes to HCV. Although at times we can feel like we will never see an end to all of the barriers that pop up in our journey towards good health, there is reason to believe we can.
Seek out help if you need it. There is never a good reason to not ask for help if you need it. There are people who can and will help you if you ask.