Hepatitis C-related discrimination among heroin users in Sydney: drug user or hepatitis C discrimination?

The hepatitis C virus (HCV) is a common infection among injecting drug users. There are currently few available data on the extent (or prevalence) of HCV-related discrimination. This study examined perceived discrimination among a sample of heroin users and sought to determine whether the discrimination was attributed to their drug user or HCV status. Heroin users were recruited through needle and syringe programmes and methadone clinics in Sydney and were asked about discrimination in the preceding 12 months. Four hundred and one heroin users were recruited, of whom 59% reported being HCV-positive. Discrimination was reported by 22% of the 237 IDUs who reported being HCV-positive, with 17% reporting that the discrimination occurred in the preceding 12 months. Sixty-seven incidents were reported, of which half were perceived to be due to their drug user status, 15% of these incidents were due to HCV status and 25% due to a combination of both. Twenty-five incidents occurred in a health-care setting, of which 13 resulted in the service being withheld. HCV is a serious public health concern, and if IDU are to be encouraged into drug treatment it is essential that service providers are perceived to be non-discriminatory. In managing IDU patients, health care workers need to be cognizant of the impact that their attitude has on treatment outcome.