What are we talking about when we talk about stigma around viral hepatitis?
Many diseases and health conditions, ranging from mental health to cancer to HIV and other sexually transmitted infections, have historically been subject to varying degrees of stigma. Hepatitis B and C are no exception. Each virus may be associated with devalued groups perceived as having greater prevalence or susceptibility to infection. Individuals with chronic viral hepatitis infection may be blamed for their status or feared as potential sources of transmission.
This stigma may extend to family members or settings that provide services and care for people living with, or at risk for, viral hepatitis. In the broader level of policy, governments and voters may be reluctant to fund services and treatment, and institutions may impose discriminatory barriers. Ultimately these layers of stigma can deter people from seeking diagnosis, disclosing their condition or risks for viral hepatitis, and access health care and support.
Interrupting stigma in everyday life
Fundamentally, stigma is an umbrella term for negative beliefs held toward certain types of individuals or groups. Stigma manifests when people express these attitudes directly, using them to shame or disparage or exclude people. For example, stigma is often at play when a group is labeled as irresponsible, dangerous, or immoral. Stigmatizing beliefs can also be encoded in discriminatory policies or everyday practices.
A key to tackling stigma head-on is speaking up when we hear or see it. Stigma against people living with viral hepatitis shows up in a variety of ways:
– Avoiding people with viral hepatitis
– Blaming them for their condition
– Assuming they don’t care about their health or can’t adhere to appointments and prescriptions
– Making it hard for them to get healthcare
– Discriminating against them in school or work
– Excluding or making negative statements about groups with high rates of viral hepatitis
These biases might show up around everyone with chronic viral hepatitis, or just certain groups, like immigrants or people who use drugs. They can manifest as subtle comments, implicit practices, and even explicit policies.
Fortunately, you don’t need to be an expert to interrupt stigma, and it’s a muscle anyone can grow with practice. Here are some ways to disrupt the flow of stigma when you encounter it:
Express skepticism: when we openly doubt or disagree with a stigmatizing statement, we signal to others (both the person expressing it, and anyone who hears it) that the stigmatizing attitude is not held by everyone and is not “common sense” or self-evident.
“I’m not sure about that.”
“That sounds like an exaggeration.”
“I’ve seen examples to the contrary.”
Probe with questions: when we sincerely question a remark or policy, we create space for the speaker or proponent to reevaluate or soften their stance.
“What do you mean by that?”
“Aren’t there exceptions?”
“Where did you hear that?”
Appeal to shared values: when we remind others of our common goals, we reground the conversation in what’s most important.
“We’re all here to make sure everyone gets the care they need.”
“Even if that’s sometimes true, we still have a responsibility to help.”
“Let’s focus on how we can support people.”
We may not always succeed in changing someone’s mind or reversing a harmful policy, but every time we speak up, we’re helping de-normalize stigma and affirming the humanity of people living with viral hepatitis.