Friday, August 14, 2009

Hep C and Social Issues

I fail to understand a world which victimizes a victim. I have several client right now, in recovery, who are positive for the Hepatitis C Virus (HCV). I’m watching them die by inches, and they can’t seem to get medical care. No insurance, no money, and lots of judgement. They vary in age from 24 to 52, all have been IV drug users, and all have been clean for 2 years to 30 years. The only thing that they have in common is HCV and a lack of medical care.

It’s estimated that 1 in ten Americans are infected with HCV. That’s four million people. Of IV drug users, estimates of hepatitis antibodies run 53-93%. Methadone maintenance programs, like where I work, have a high incidence of hepatitis antibodies of 67-96%. The literature supports treatment for patients in methadone maintenance, but most never receive treatment. So I watch my client grow sick, seek treatment, and not receive it.

For an in depth look at HCV and treatment, watch this:

According to Hepatitis Central, "More people are currently living with HCV than any other chronic blood-borne infectious disease." They go on to say that the stigma becomes more harmful than the illness. Certainly seems to be happening to my clients within the medical community. Indeed, social identity theory categorizes people based upon whether they are a member of the in group or the out group. Self-esteem is related to the position to out group. Furthermore, the in group will protect itself, rejecting those who do not fit their group. So healthcare providers may associate those with hepatitis as stereotype (IV drug user, for example). Consequently, healthcare providers may discriminate against hepatitis patients. Patients pick up on the disapproval of their perceived lifestyle and social group membership. I watch them go from doctor to doctor, and be turned away time after time. My heart is breaking for them.


  1. When I read what you have written, when I see the people under your care and you both together struggling to overcome the illness and the social stigmas, when I read about it in research, I am transported back to the 80's and early 90's and even into the begining years of 2000 and the new millinium and the rise and devestation of AIDS. It is all too familiar a feeling. Hep C is the "new AIDS", except without the activism. the rallying cries, the Quilt...perhaps without the hope. I don't see it in the news. I don't see marches or signs. And I see in your eyes the feelings I had when I watched one of my dearest friends die of AIDS by inches. What it all comes down to is the lack of respect for human life - the jugdements, the justifications, the arrogance, the fear. And the sad thing is that AIDS is not conquored, or over or beaten - it is still horribly with us; just now our of fashion. We live with a generation who now have never known a world without AIDS, who cannot understand such a thing. Who think nothing of it. How does that connect with the lack of understanding of Hep C? It's just another one of those illnesses...such horrors are commonplaces in todays world, and they can stick their heads in the sand and ignore such things as long as AIDS and Hep C doesn't affect them directly. (unfortunately, Hep C and AIDS can be co-morbid. There's a thought!) This is driven by patriarchy and shallow fundementalism and greed. And if those who contract these illnesses are minimalized and shoved aside - just women, drug addicts, queers; not real people, not people like "us" - then they can be safely ignored.

    I am here and I will listen when you need to vent, and hold you when you need to cry and work with you for, someday, a better world.

  2. He's a keeper Dreamweaver!

    Cameron...I will mildly dispute one section.

    Been sewing long? Your bias is showing. Smile.

    "This is driven by patriarchy and shallow fundamentalism and greed. And if those who contract these illnesses are minimalized and shoved aside - just women"

    Patriarchy. Fun word. I don't see it though. Especially when I've watched women avoid me, belittle me, and refuse to serve me. Especially those on the lesbian community. I'm swinging back to the dung heap analogy again. Everyone is so fast to point a finger at someone else, to be superior, mentally, ethically, financially, racially, sexually.. take your pick.. Trying so hard to be at the top if the dung heap and blame everyone else for the dung heap...rather than not pointing fingers but instead reaching out to join hands and escape the dung heap.

    "If we do not hang together, we shall surely hang separately."
    Thomas Paine

    I don't know that you are wrong in this case, but we lower ourselves when we make blanket statements about any group.

  3. Oh my beloved friend, Alissa, I am so sorry to hear the pain of rejection from a community that should embrace you. You've lost "patriarchical privilege" with a transition to female. And then been rejected by the lesbians. I have to wonder, after reading so much by Helen Boyd, what Betty would say? I simply had not realized just how rejecting the lesbian community would be once you transitioned.

    I read somewhere that the heterosexual community usually winds up the support system for long-term gay/lesbian relationships. We abandon the bars and the drama to form a relationship, and our own community then becomes part of the problem rather than a safe, supportive community. Heartbreaking. And for you, just another layer of rejection. You've given me food for thought.