Self-Perceived Stigma and Barriers to Testing and Treatment for Hepatitis C: A Mixed Method Study
Keywords:
Hepatitis C, Stigma, Testing barriers, Treatment barriers, Rural health, HCVAbstract
Background: Hepatitis C virus (HCV) infection remains an important public health concern, particularly in rural populations where stigma, inadequate knowledge and difficulties in accessing healthcare may delay diagnosis and treatment. Understanding self-perceived stigma and barriers to HCV care is essential for improving engagement with treatment services.
Aims: To estimate the prevalence of self-perceived stigma among HCV-positive patients, identify barriers associated with HCV testing and treatment, and explore healthcare providers’ perspectives regarding these barriers.
Materials and Methods: A hospital-based mixed-method study was conducted among 170 HCV-positive patients at the Hepatitis C Clinic/Medicine OPD of BPS Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, from August 2023 to November 2024. Consecutive sampling was used. Stigma was assessed using the 33-item Hepatitis C Virus Stigma Scale. The qualitative component included 4 FGDs and 8 IDIs involving patients and healthcare providers.
Results: The mean age was 45.90 ± 15.55 years; 50.6% were male and 49.4% female, while 78.2% were rural residents. Illiteracy was reported in 34.7%, and 52.9% had a monthly family income below ₹10,702. Symptom-based diagnosis was most common (48.2%), and 77.1% had been diagnosed within 0–3 months. Treatment initiation occurred within 1–3 months in 41.8%. Overall, 28.2% experienced self-perceived stigma. Stigma was significantly associated with age (p<0.001) and other drug addiction (p=0.027), but not sex (p=0.263), caste (p=0.340), education (p=0.065) or comorbidity (p=0.313). No high-risk behaviour showed a statistically significant association with stigma.
Conclusion: Self-perceived stigma affected a substantial proportion of participants and was associated particularly with age and drug addiction. Improved awareness, stigma-sensitive counselling and accessible, timely HCV services are needed.
