How Did I Get Hep C?
In all of its different versions, this has to be the most common thing I hear from people who are newly diagnosed with hep C. I asked the same question myself when the news came, but it makes no difference unless we are concerned about others who may have been exposed at the same time as us and we want to inform them. Unfortunately, because of the link made by most people between hep C and drug use, there is a stigma that carries great burden for most of us who have lived with a hep C diagnosis.
Elimination of hep C & the stigma
Elimination of hep C by 2030 is a target set by the World Health Organization (WHO) and the World Hepatitis Alliance (WHA), along with lots of countries and civil society organizations who have aligned and signed. Many who work in the public health sector have chosen to focus on the drug using population. Treatment as Prevention (TasP) is one of the models that have been adopted as a way of preventing new exposure to hep C (transmission) by the so-called “core transmitters” (drug users) which is a phrase I despise deeply. To classify a segment of people or “population” in their parlance, as “core transmitters” just feels wrong.
It is understandable to have demographic profiles of distinct at risk groups of people when it comes to designing and implementing actions to address the different populations. It is also important to remember that a cookie-cutter approach to hep C or any other disease is wrong-minded and that it creates gaps in care for those people who do not fit into a predetermined box that inevitably needs ticking, stigma aside.
It does not matter how we get hep C
Getting back to the title question, it comes down to one basic answer for me and that is; it does not matter how we get hep C. Most people do move on from racking their mind on just how they got hep C unless they know or feel discriminated against or marginalized by the diagnosis, cured or not. Generally, hep C is still associated with drug use and in most circles, drug use is frowned upon to say the least. The current crisis we see with opioid addiction and what seems like endless deaths caused by overdose, the focus has understandably shifted away from infectious disease risk in the general discourse about drug use. Whether there will be a meaningful and sustained approach to the crisis remains to be seen, and in a population where we see threat to life that drugs like Fentanyl present, it is not surprising that hep C is taking a back seat as far as risk and harm reduction, and I hope it is not lost in the overwhelming need to prevent more deaths from these deadly drugs.
In the population most impacted by hep C, that are not considered to be transmitters of the virus, we are seeing the progression of the disease over time take its toll. If we are going to focus our efforts primarily on preventing new infections we will see diminished quality of life, lost days of work forcing, financial burden, more complications, and conditions caused by hep c, with more preventable deaths. You bet, bringing older people living with hep C into care and treatment is not going to end hep C by 2030, but without more robust testing programs. and better linkage to care we will see more deaths across all populations. That certainly is the end of hep C for them, but is that the best approach? Of course not no matter how, where, or when they were exposed to the virus.