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COVID-19 vaccination is particularly challenging among populations who have experienced discrimination in healthcare settings. This paper presents qualitative findings from in-depth interviews about COVID-19 vaccination conducted in Australia between October 2020 and November 2021. Data from four different studies are presented; each population has unique experiences of discrimination within the healthcare system: Aboriginal people; people who inject drugs (PWID); people living with HIV (PLHIV); and gay and bisexual men (GBM). Analyses were guided by the behavioural and social determinants model that forms the basis of the World Health Organization's "data for action: achieving high uptake of COVID-19 vaccines" interim guidance. All populations viewed vaccination as necessary for community protection, although narratives of community care were most common among Aboriginal people. Concerns about vaccine safety were expressed by all participant groups, although participants living with HIV and GBM were more trusting of vaccines possibly because of their ongoing and usually positive past experiences with biomedical technologies for HIV management and sexual health. Aboriginal participants reported distrust of mainstream government and participants who inject drugs expressed a more generalised suspicion about COVID-19 and its origins. Practical problems related to transport, booking appointments for vaccination and so forth, were more common among participants living with HIV and GBM, possibly because these specific interviews were conducted throughout 2021 when vaccines were more available, whereas data for the other populations were collected before the vaccine rollout. Findings show that vaccine willingness is shaped by past experiences of discrimination in healthcare setting, but different histories of discrimination can differently impact vaccine willingness. Promotional messaging and delivery must take account of these important differences so to not treat these populations homogenously. [ABSTRACT FROM AUTHOR]

Research suggests that hepatitis C virus (HCV) transmission is more likely among gay and bisexual men (GBM) who engage in sexually adventurous practices, including group sex while using drugs. The current study explored drug use, sexual practices, HCV knowledge, HCV disclosure, and beliefs about HCV transmission among GBM (n = 193) reporting group sex after/while using drugs compared to those who did not. Survey findings indicate that men who participated in group sex while using drugs were more likely to have engaged in other sexually adventurous practices, ever injected drugs, have greater knowledge of HCV, and to be living with HIV. They were also more likely to perceive themselves at risk of acquiring HCV and to know that their sexual activities put them at risk. Interestingly, they had lower expectations of HCV disclosure and were less concerned about the HCV status of their partners. The lower expectations around disclosure and concern about the HCV status of their partners reflect the challenges for GBM in managing HCV transmission where there are limited effective behavioural strategies for reducing sexual transmission, This research also highlights the need to promote HCV testing and treatment to GBM who engage in group sex while using drugs. [ABSTRACT FROM AUTHOR]