Related Experiment Videos
A dirty little secret: stigma, shame and hepatitis C in the health setting
Insights
Hepatitis C (HCV) patients face significant stigma, particularly when disclosing their bloodborne virus (BBV) status in healthcare settings. This disclosure dilemma can lead to suboptimal care due to fear of discrimination.
Area of Science:
- Medical Sociology
- Public Health
- Infectious Diseases
Background:
- Hepatitis C (HCV) remains a stigmatized bloodborne virus (BBV), often associated with injecting drug use.
- Stigma surrounding HCV creates significant challenges for individuals, particularly within healthcare environments.
- Disclosure of HCV status can place individuals in vulnerable positions due to societal perceptions of disease and deviance.
Purpose of the Study:
- To examine the disclosure dilemmas faced by individuals with Hepatitis C (HCV) in healthcare settings.
- To analyze the impact of stigma on the decision-making process regarding disclosure of HCV status.
- To explore the role of healthcare professionals' responses in perpetuating or mitigating HCV stigma.
Main Methods:
- Qualitative study utilizing Goffman's model of social identities and Douglas's notion of dirt and pollution.
- Analysis of the ethical and practical considerations influencing disclosure decisions for HCV patients.
- Examination of discriminatory responses within healthcare settings and their consequences.
Main Results:
- Disclosure of HCV status in health settings can lead to vulnerability and stigmatization.
- Healthcare professionals' discriminatory responses can exacerbate the stigma associated with HCV.
- Fear of stigma and discrimination contributes to reticence in disclosing HCV status, potentially impacting healthcare quality.
Conclusions:
- Stigma associated with Hepatitis C (HCV) is a persistent issue within healthcare settings.
- Addressing discriminatory practices and improving patient-provider communication is crucial for mitigating HCV stigma.
- Reducing stigma is essential for ensuring individuals with HCV receive optimal and non-discriminatory healthcare.
Abstract:
While recent medical innovation shows great promise in treating hepatitis C (HCV), it remains a condition associated with profound stigma. HCV is a bloodborne virus (BBV) most commonly transmitted in high-income countries by injecting drug use, and it is the stigmatising association between the two which is deeply problematic for those with HCV. A qualitative study undertaken in 2002 found that disclosure in health settings places those with HCV in positions of pronounced vulnerability. Disclosure is a primal scene, an interface, where the stigma of HCV, replete with connotations of disease and deviance, potentially transforms those affected into shamed subjects. Standard precautions protect health workers and minimise the transmission of contagion, measures which, in theory, also mitigate the requirement of those with BBVs to unnecessarily disclose their blood status. However, questions on pre-employment health checks, concerns that health treatments might adversely affect the liver and an ethical need to pre-emptively inform healthcare professionals undertaking exposure prone procedures are occasions when those with HCV confront the decision to disclose their blood status. This paper employs Goffman's model of actual and virtual social identities, along with Douglas' notion of dirt and pollution, to examine the dilemmas around disclosure those with HCV negotiate within the health setting. Discriminatory responses by healthcare professionals elucidate the stigmatising potential HCV carries. The subsequent reticence by those with HCV to disclose their blood status risks less than optimum healthcare. Recent studies indicate that stigma occurring in health settings remains a perennial concern for those with HCV.