Barriers and enablers to hepatitis C treatment among clients of Aboriginal Community Controlled Health Services in South East Queensland, Australia: a qualitative enquiry
Cheneal Puljević
A B , Luciana Massi C , Renee Brown D , Richard Mills D , Lyle Turner D , Andrew Smirnov A and Linda A. Selvey A *
+ Author Affiliations
- Author Affiliations
A School of Public Health, The University of Queensland, 288 Herston Road, Brisbane, Qld 4006, Australia.
B Centre for Health Services Research, The University of Queensland, Brisbane, Qld 4006, Australia.
C Molly Wardaguga Research Centre, College of Nursing & Midwifery, Charles Darwin University, Brisbane, Qld 4000, Australia.
D The Institute for Urban Indigenous Health, Brisbane, Qld 4030, Australia.
* Correspondence to: l.selvey@uq.edu.au
Australian Journal of Primary Health 28(3) 239-246 https://doi.org/10.1071/PY21055
Submitted: 9 March 2021 Accepted: 5 December 2021 Published: 9 February 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University.
Abstract
Background: Aboriginal and Torres Strait Islander Australians have disproportionately high rates of hepatitis C infection. Aboriginal Community Controlled Health Services play an important role in promoting hepatitis C treatment, but uptake is variable. This study explores the service-level barriers and enablers to hepatitis C screening and treatment among clients of Aboriginal Community Controlled Health Services in South East Queensland.
Methods: This qualitative study involved yarns with 16 clients and 40 healthcare providers. Thematic analysis was used to identify common barriers and enablers to hepatitis C screening and treatment.
Results: Common barriers included healthcare providers’ knowledge deficits and inaccurate perceptions of clients’ ability to complete treatment, whereas clients described stigma that resulted in distrust of health care, and experiences of poor relationships and connections with healthcare providers. Enablers included Aboriginal governance of Aboriginal Community Controlled Health Services and the ease of direct-acting antiviral treatment.
Conclusions: This study’s findings point to the need for healthcare worker training focussing on client autonomy, reduced hepatitis C-related stigma, and consideration of clinicians’ roles in increasing service engagement. Addressing the barriers to hepatitis C treatment through client-focussed service improvement may promote increased hepatitis C screening and treatment among Aboriginal and Torres Strait Islander Australians.
Keywords: Aboriginal and Torres Strait Islander health, Community Health Services, health personnel, hepatitis C, delivery of health care, Indigenous Health Services, qualitative research, Queensland.
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