Module 10: Treatment quality, stigma and discrimination - section 1

In this document:

Hepatitis C and stigma

Activity: Group discussion
Section Time: Approximately 15 minutes

This activity allows some initial discussion of stigma with reference to HCV and injecting.

Show Slide 10.2 (Hepatitis C: status and blame) and give participants time to read the quote:     

To facilitate this discussion

  • Ask the group to discuss this quotation and the way it relates to their views and experiences
  • Does HCV have secondary status?
  • Is HCV much more likely to be seen to denote injecting?
  • What examples can people give from their own experiences that either support or contradict this?

Stigma is defined in various ways. In a 2010 review of stigma and ‘problem drug use’, Charlie Lloyd offers this explanation:

“Stigmatisation occurs when a person possesses an attribute or status (a ‘stigma’) that makes that person less desirable or acceptable in other people’s eyes and which thereby affects their interactions with others. While at one level, we have all been stigmatised and all been stigmatisers at some point in the past, this phenomenon becomes much more serious when the stigma takes centre stage, to the obscuration of the rest of a person’s identity: when it becomes a ‘master status’. Problem drug use is one such master status.”

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Hepatitis C: experiences of stigma and discrimination

Activity: Group discussion
Section Time: Approximately 30 minutes

This activity encourages participants to examine ways that stigma may be communicated within their own service and any ways that this has been challenged.

Show Slide 10.3 (Hepatitis C: experiences of stigma and discrimination) and ask participants, while in the large group, to consider the quoted experiences:

To facilitate this activity:

  • Divide participants into small groups and ask them to identify ways in which stigma may be communicated to people with HCV in their service/treatment system/community
  • Encourage people to provide examples where possible (including any where this has been challenged/changed).
  • Ask each group to feed back to the group and discuss ways they could improve their understanding of experiences of stigma/discrimination for people with HCV in their setting
  • If the discussion stalls, possible options to consider are: meeting local/national HCV advocacy/support groups; asking patients about this during day-to-day encounters in your service; commissioning independent research; local audits that ask people to ‘walk’ through the treatment journey and reflect on their experiences at each stage; or, ‘secret shoppers’ who conceal their identity and approach services to provide ‘real-life’ accounts of how they are welcomed and what information they receive.
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Different populations

Activity: Information with group discussion
Section Time: Approximately 10 minutes

This activity promotes reflection on cross-cutting sources of stigma and discrimination.

Show Slide 10.4 (Cross-cutting factors) :

To facilitate:

  • Use the slide to identify cross-cutting ways by which stigma and obstacles to service use can arise
  • Discuss these with the group in the context of their own settings
  • Explore whether national or local equal opportunities or anti-discrimination practice legislation, policies, codes or guidance apply.
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