“We are studying abroad and need to protect ourselves first”: A mixed-methods study of attitudes towards hepatitis B among university students in Australia of Chinese and Vietnamese background

Abstract

Abstract Introduction Hepatitis B is a significant public health concern and a leading cause of liver cancer across the world. In Australia, hepatitis B is largely endemic in migrant communities, particularly amongst the Chinese and Vietnamese communities. Negative attitudes towards hepatitis B can be a major barrier to hepatitis B testing and linkage to care. This mixed-methods research explores the attitudes and beliefs, including stigma, about hepatitis B among students of Vietnamese and Chinese background in Australia as students provide a point of entry to communities that otherwise may be hard to access. Methods Online surveys were distributed in Chinese, Vietnamese, and English via social media and completed by 112 students of Chinese and 95 students of Vietnamese backgrounds. Interviews were then conducted with 13 Vietnamese and 10 Chinese participants. In-depth interviews were also conducted to further explore the survey results in more details. Results Survey findings suggest that students have mixed attitudes towards people living with hepatitis B. Around half of the participants reported they would behave negatively towards other people with hepatitis B and that they would expect to experience stigma or discrimination if they had hepatitis B. While over 70% in both samples reported that people who have hepatitis B should not be isolated by family and friends, 47.6% of the Chinese sample and 28.3% of the Vietnamese sample reported they would avoid close contact with someone with hepatitis B. Similarly, contradictory explanations around hepatitis B stigma were noted in the qualitative data which supports the quantitative findings that stigma is driven by fear of contagion and misinformation about the virus. Conclusion This research provides insights that could inform culturally sensitive health promotion programs to address negative attitudes towards hepatitis B among the broader Chinese and Vietnamese communities living in Australia.