The unvirtuous cycle of discrimination affecting people with hepatitis B: a multi-country qualitative assessment of key-informant perspectives
Abstract Background An estimated 296 million individuals live with chronic hepatitis B worldwide, most have not been diagnosed and remain at risk of liver disease and cancer. People with hepatitis B often face discrimination that denies them employment or education opportunities, results in unfair t...
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12939-022-01677-6 |
| _version_ | 1811240110768783360 |
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| author | Catherine Freeland Lindsay Mendola Vivian Cheng Chari Cohen Jack Wallace |
| author_facet | Catherine Freeland Lindsay Mendola Vivian Cheng Chari Cohen Jack Wallace |
| author_sort | Catherine Freeland |
| collection | DOAJ |
| description | Abstract Background An estimated 296 million individuals live with chronic hepatitis B worldwide, most have not been diagnosed and remain at risk of liver disease and cancer. People with hepatitis B often face discrimination that denies them employment or education opportunities, results in unfair treatment at work or in school, limits their ability to emigrate to certain countries, and in some cases prohibits them from serving in the military. Discrimination specific to hepatitis B has not been widely documented within the literature. This study aims to investigate and describe hepatitis B related discrimination, document discrimination occurring around the globe, and provide initial recommendations for addressing discrimination using key informant interviews. Methods Purposive and snowball sampling were used to identify potential key informants for qualitative interview. Key informants identified as community health leaders, public health scientists, doctors, and researchers, many of whom were also living with hepatitis B. Using a semi-structured guide, participants were asked to describe their experience and any challenges for people living with hepatitis B including marginalization and its’ consequences. A codebook was used to guide the organization of data for analysis, and all transcripts N = 17 were double coded. Results The overarching themes identified from interviews demonstrate explicit experiences with discrimination of those directly affected, the psychological responses, and the negative health outcomes associated with the unvirtuous cycle of discrimination. All key informants reported on the substantial quality of life implications and often poorer health outcomes resulting from hepatitis B discrimination. Participants also identified the significant impact of hepatitis B discrimination occurring within a range of education-based services across several countries as well as military exclusion or removal if individuals are found to have hepatitis B. Conclusion Our data demonstrate that hepatitis B discrimination has a significant impact. Discrimination can occur at various points in life from education, to seeking employment, to marriage, to restrictions on entry, travel and stay in other countries. This study demonstrates the impact of discrimination and the need for future research that can lead to policy change and protections for people living with and impacted by hepatitis B. |
| first_indexed | 2024-04-12T13:13:34Z |
| format | Article |
| id | doaj.art-ebb6c23f83cc47db91855597dbf4b384 |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-04-12T13:13:34Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-ebb6c23f83cc47db91855597dbf4b3842022-12-22T03:31:47ZengBMCInternational Journal for Equity in Health1475-92762022-05-0121111010.1186/s12939-022-01677-6The unvirtuous cycle of discrimination affecting people with hepatitis B: a multi-country qualitative assessment of key-informant perspectivesCatherine Freeland0Lindsay Mendola1Vivian Cheng2Chari Cohen3Jack Wallace4Hepatitis B FoundationTemple UniversityArcadia UniversityHepatitis B FoundationBurnet InstituteAbstract Background An estimated 296 million individuals live with chronic hepatitis B worldwide, most have not been diagnosed and remain at risk of liver disease and cancer. People with hepatitis B often face discrimination that denies them employment or education opportunities, results in unfair treatment at work or in school, limits their ability to emigrate to certain countries, and in some cases prohibits them from serving in the military. Discrimination specific to hepatitis B has not been widely documented within the literature. This study aims to investigate and describe hepatitis B related discrimination, document discrimination occurring around the globe, and provide initial recommendations for addressing discrimination using key informant interviews. Methods Purposive and snowball sampling were used to identify potential key informants for qualitative interview. Key informants identified as community health leaders, public health scientists, doctors, and researchers, many of whom were also living with hepatitis B. Using a semi-structured guide, participants were asked to describe their experience and any challenges for people living with hepatitis B including marginalization and its’ consequences. A codebook was used to guide the organization of data for analysis, and all transcripts N = 17 were double coded. Results The overarching themes identified from interviews demonstrate explicit experiences with discrimination of those directly affected, the psychological responses, and the negative health outcomes associated with the unvirtuous cycle of discrimination. All key informants reported on the substantial quality of life implications and often poorer health outcomes resulting from hepatitis B discrimination. Participants also identified the significant impact of hepatitis B discrimination occurring within a range of education-based services across several countries as well as military exclusion or removal if individuals are found to have hepatitis B. Conclusion Our data demonstrate that hepatitis B discrimination has a significant impact. Discrimination can occur at various points in life from education, to seeking employment, to marriage, to restrictions on entry, travel and stay in other countries. This study demonstrates the impact of discrimination and the need for future research that can lead to policy change and protections for people living with and impacted by hepatitis B.https://doi.org/10.1186/s12939-022-01677-6Hepatitis B virusStigmaDiscriminationHuman rightsMarginalizationHealth outcomes |
| spellingShingle | Catherine Freeland Lindsay Mendola Vivian Cheng Chari Cohen Jack Wallace The unvirtuous cycle of discrimination affecting people with hepatitis B: a multi-country qualitative assessment of key-informant perspectives International Journal for Equity in Health Hepatitis B virus Stigma Discrimination Human rights Marginalization Health outcomes |
| title | The unvirtuous cycle of discrimination affecting people with hepatitis B: a multi-country qualitative assessment of key-informant perspectives |
| title_full | The unvirtuous cycle of discrimination affecting people with hepatitis B: a multi-country qualitative assessment of key-informant perspectives |
| title_fullStr | The unvirtuous cycle of discrimination affecting people with hepatitis B: a multi-country qualitative assessment of key-informant perspectives |
| title_full_unstemmed | The unvirtuous cycle of discrimination affecting people with hepatitis B: a multi-country qualitative assessment of key-informant perspectives |
| title_short | The unvirtuous cycle of discrimination affecting people with hepatitis B: a multi-country qualitative assessment of key-informant perspectives |
| title_sort | unvirtuous cycle of discrimination affecting people with hepatitis b a multi country qualitative assessment of key informant perspectives |
| topic | Hepatitis B virus Stigma Discrimination Human rights Marginalization Health outcomes |
| url | https://doi.org/10.1186/s12939-022-01677-6 |
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