Affiliation:
1. Australian Research Centre in Sex, Health and Society La Trobe University Bundoora Victoria Australia
2. Social Policy Research Centre University of New South Wales Sydney New South Wales Australia
Abstract
AbstractModern health‐care systems have customarily approached hepatitis C in ways that resemble the public health approach to HIV/AIDS known as ‘HIV exceptionalism’. HIV exceptionalism describes the unusual emphasis on privacy, confidentiality and consent in approaches to HIV and was partly developed to address HIV/AIDS‐related stigma. In the case of hepatitis C, exceptionalist approaches have included diagnosis and treatment by specialist physicians and other ‘boutique’ public health strategies. The recent availability of highly effective, direct‐acting antivirals alongside goals to eliminate hepatitis C have heralded dramatic changes to hepatitis C health care, including calls for its ‘normalisation’. The corollary to exceptionalism, normalisation aims to bring hepatitis C into routine, mainstream health care. This article draws on interviews with stakeholders (n = 30) who work with hepatitis C‐affected communities in policy, community, legal and advocacy settings in Australia, alongside Fraser et al.’s (2017, International Journal of Drug Policy, 44, 192–201) theorisation of stigma, and Rosenbrock et al.’s (1999, The AIDS policy cycle in Western Europe: from exceptionalism to normalisation. WZB Discussion Paper, No. P 99‐202) critique of normalisation to consider the perceived effects of hepatitis C normalisation. Stakeholders described normalisation as a stigma‐reducing process. However, they also expressed concerns about the ongoing stigma and discrimination that is not ameliorated by normalisation. We suggest that in centring normalisation, changes in health care may exaggerate the power of technological solutions to transform the meanings of hepatitis C.
Funder
Australian Research Council
Subject
Public Health, Environmental and Occupational Health,Health Policy,Health (social science)
Reference61 articles.
1. Australian Department of Health. (2018).Fifth national hepatitis C strategy 2018–2022. Commonwealth of Australia (Canberra).https://www1.health.gov.au/internet/main/publishing.nsf/Content/ohp‐bbvs‐1
2. Authorised nurse practitioners now eligible to prescribe certain highly specialised drugs;Australian Department of Health and Aged Care;PBS News,2020
3. Australian Government Department of Health and Aged Care. (2015).Hepatitis C – CDNA National Guidelines for Public Health Units. Retrieved March 28 2023 fromhttps://www.health.gov.au/resources/publications/hepatitis‐c‐cdna‐national‐guidelines‐for‐public‐health‐units
4. Interventions to enhance testing, linkage to care and treatment uptake for hepatitis C virus infection among people who inject drugs: A systematic review
5. Public Health Policy and the AIDS Epidemic