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Hepatitis C (HCV) is a stigmatised disease due, in part, to an association with injecting drug use. Aboriginal Australians, a stigmatised group, are over-represented in patterns of HCV infections. We examined the experience of Aboriginal Australians living with HCV using qualitative in-depth interviews, paying particular attention to instances where multiple stigma mechanisms (relating to HCV, injecting drug use and Aboriginal identity) overlapped. Stigma held a central role in the experience of most of the 39 participants with reports of exclusion and alienation from families and communities. HCV-related stigma was accompanied by the notion of 'shame' which holds deep cultural significance for Aboriginal people. Participants' accounts revealed overlapping stigma in their perception that others 'automatically' expect Aboriginal people to have a stigmatised disease such as HCV. HCV as a contemporary expression of colonisation was also woven into accounts of HCV-related stigma. Interventions to reduce HCV stigma should be specifically designed for minority populations to account for multiple, overlapping sources of stigma. [ABSTRACT FROM AUTHOR]

Introduction. Despite Aboriginal Australians being over-represented in populations of people living with hepatitis C (HCV), there is a dearth of research to guide policy and programme development in the area of care and treatment, particularly relating to new HCV treatments. Method. In-depth interviews were conducted with 39 people identifying as Aboriginal Australians and living with HCV in New South Wales. Results. Participants' experiences were characterised by a lack of detailed or appropriate information provided at diagnosis, high levels of stigma associated with HCV and low overall knowledge of HCV as reported for themselves and their communities. Despite poor diagnosis experiences, participants had undertaken changes to their lifestyle, especially in relation to alcohol use, in order to promote liver health. Concerns about treatment side effects and efficacy impacted participants' decisions to undertake treatment. Eleven participants had undertaken HCV treatment in a variety of care models with a peer worker and in prison. Conclusions. The similarities between concerns and experiences of Aboriginal people and other populations living with HCV do not suggest that services and strategies to engage these populations should also be the same. These results suggest that further engagement of the primary care sector in HCV care is important as well as increasing Aboriginal community knowledge of HCV. A variety of service models should be available to meet individuals' preferences, including those offered within Aboriginal community controlled health services emphasising holistic notions of health, and supported by information and communication programmes using principles of health literacy relevant to Aboriginal people. [ABSTRACT FROM AUTHOR]