Delivering the hepatitis C cure to Aboriginal people: documenting the perspectives of one Aboriginal Health Service
Jack Wallace A B E , Bev Hanley C , Mary Belfrage D , Sandra Gregson D , Niall Quiery D and Jayne Lucke BA Burnet Institute, 185 Commercial Road, Melbourne, Vic. 3004, Australia.
B Australian Research Centre in Sex, Health and Society, La Trobe University, Building NR6, Bundoora, Vic. 3086, Australia.
C Deceased. Victorian Aboriginal Health Service, 186 Nicholson Street, Fitzroy, Vic. 3065, Australia.
D Victorian Aboriginal Health Service, 186 Nicholson Street, Fitzroy, Vic. 3065, Australia.
E Corresponding author. Email: jack.wallace@burnet.edu.au
Australian Journal of Primary Health 24(6) 491-495 https://doi.org/10.1071/PY18024
Submitted: 1 February 2018 Accepted: 17 July 2018 Published: 19 October 2018
Abstract
Aboriginal and Torres Strait Islander peoples are disproportionately affected by hepatitis C, an infection that is curable with direct acting antivirals (DAAs). The Australian Government funded access to DAAs from March 2016 for all people with hepatitis C, with primary care physicians, along with clinical specialists, permitted to prescribe these treatments. The Victorian Aboriginal Health Service, in recognising the effect of liver disease from viral hepatitis within their community, and of the increased availability to DAAs, established a Liver Clinic to facilitate access to treatment for people attending the service. This study conducted semi-structured interviews to document the health service provider perspectives on the barriers and enablers to treatment; explored patients’ experiences of hepatitis C treatment and cure; and sought to identify possible health system-level changes to facilitate increased access and uptake of treatment by Aboriginal people. The study found the success of the clinic was supported by the multidisciplinary and accessible nature of the health service, and the relationships built over time between clinic staff and people with, or at risk of, hepatitis C. For those treated, the individual effect of the cure not only eliminated the hepatitis C virus, but reduced shame and increased broader social participation.
Additional keywords: health services: accessibility, health services: indigenous, Indigenous health services, primary health care.
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