Hepatitis C Stigma Doesn’t Discriminate

Last year, a hepatitis C prescription was sent to my pharmacy from an infectious disease clinic. The clinic noted that this was a new patient to our pharmacy. I then contacted the patient in an attempt to coordinate the treatment start date and drug coverage. The patient didn’t answer the phone, but to my surprise, showed up to the pharmacy an hour later.

My experience dealing with this particular patient – we will call him M -- was very different from the prior patients I had. M didn’t seem scared, worried, or unease about his diagnosis. Furthermore, he came in rather excited to start treatment; Jowever, what was most striking was his apparent absence of embarrassment regarding his diagnosis. Usually, a part of my counseling with patients involved reassurance about the stigma that they may face; Many people admit their fear of disclosing their diagnosis to their loved ones. That wasn’t the case for M.

M told me that he is a recent immigrant from Egypt. M’s reaction to his diagnosis led me to wonder whether it was a unique, individual reaction, or whether ethnic differences in hepatitis c perception exist. This is, are people more likely to encounter hepatitis C stigma in Western culture than other cultures?

Hepatitis C stigma in Egypt

Egypt has the highest prevalence of hepatitis C in the world, at 12.5-26.6% of the population.¹ The primary mode of transmission in Egypt has been through the contaminated transfusions and infected needles.

A recent study sampled 260 patients with hepatitis C in Egypt. The results showed that:²

• 20% reported that they do not feel the same as others
• 21% feel dirty
• 43% indicated that their diagnosis makes them feel like they are a bad person
• 25% felt that people with hepatitis C are rejected
• 26% were hurt by the reaction of their loved ones

What this information means

The stigma surrounding hepatitis C in western countries is primarily due to injection drug use, which creates an unfair blame on everyone who acquires the virus. Even in a country where the primary mode of transmission is known to be through contaminated blood products, stigma is still prevalent.

The effects of hep C stigma

Stigmatization impacts health outcomes and can reduce quality of life for individuals with Hepatitis C. Often for people with hepatitis C, the stigma of the virus causes more harm than the virus itself. The stigma often leads some people to experience a disregard for their well-being, shame, social isolation, loss of their income, a decrease in self-esteem, and feelings of being "unclean".³

Hepatitis C stigma, in many ways, does not discriminate – it affects people of all cultures and backgrounds. To continue to make progress to address and tackle stigmatization, we must continue to advocate and educate the public, including healthcare professionals, about the harmful effects of stigma.