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Aim: A cross-sectional study was conducted to explore knowledge of viral hepatitis among attendees of an Australian metropolitan university. Method: A short survey enquiring into viral hepatitis A, B and C (HAV, HBV and HCV, respectively) was administered to a convenience sample of people at a campus in Sydney, Australia during September 2011. Results: A total of 340 participants completed the survey. Among this sample, the risks for transmission of viral hepatitis, particularly HCV, were generally well understood; however, there were substantial gaps in knowledge about the hepatitis vaccines and treatments. Univariate analyzes indicated that participants who reported religion as unimportant to them had better overall knowledge about HBV and HCV than people for whom religion was reportedly important. Similarly, participants without children had better knowledge of HCV than participants who had children. Conclusions: Although the sample was not representative, these findings suggest that among Australians more work is needed to promote knowledge of HAV and HBV vaccines and HBV and HCV treatments. It is prudent to educate young people about the risks for viral hepatitis before they are sexually active, engaging in injecting drug use or planning body modification. (Contains 1 table.)

Australian Aboriginal and Torres Strait Islanders are overrepresented in both the prevalence and incidence of the hepatitis C (HCV). HCV knowledge has been associated with a range of positive health behaviours. HCV knowledge has previously been investigated as a single construct; however examining different knowledge domains (i.e. transmission, risk of complications, testing and treatment) separately may be beneficial. This study investigated whether having greater HCV knowledge in different domains is associated with self-reported positive health behaviours. 203 Aboriginal people living with HCV completed a survey assessing HCV knowledge, testing and care, lifestyle changes since diagnosis and treatment intent. Respondents’ knowledge was relatively high. Greater knowledge of risk of health complications was associated with undertaking more positive lifestyle changes since diagnosis. Respondents testing and treatment knowledge was significantly associated with incarceration, lifestyle changes since diagnosis and future treatment intentions. This study illustrates the importance of ensuring that knowledge is high across different HCV domains to optimise a range of positive health behaviours of Aboriginal people living with HCV. Future health promotion campaigns targeted at Aboriginal people living with HCV could benefit from broadening their focus from prevention to other domains such as testing and treatment. [ABSTRACT FROM PUBLISHER]

Aims: Currently, efforts to prevent hepatitis C virus (HCV) focus on the message that all sharing of injecting equipment is risky. This obscures the strategies undertaken by people who inject drugs (PWID) to reduce risk of transmission to themselves and others.Methods: Self-complete survey of clients of Needle and Syringe Programs (NSPs) in a metropolitan area of Sydney, Australia. Among those who reported sharing injecting equipment, two categories of risk were constructed based on self-perceived HCV status and self-reported distributive and receptive sharing of injecting equipment. The “higher risk” category contained participants who reported being either HCV-positive and distributive sharing or HCV-negative and receptive sharing. The “lower risk” category contained participants who reported being either HCV-positive and receptive sharing or HCV-negative and distributive sharing.Findings: Around a third of the total sample were categorised as “higher risk”. In multivariate analysis, being in the higher risk category was associated with perceived difficultly in managing drug use (adjusted odds ratio (AOR) = 2.37; 95% CI 1.34–4.18;p = 0.003) and having less trust in drug and alcohol workers (AOR = 0.68; 95% CI 0.52–0.90;p = 0.007).Conclusions: This exploratory study highlights gaps in the way that the HCV prevention sector understands and addresses risk. Further research is required to guide prevention efforts that are meaningful and relate to the strategies that PWID undertake to reduce HCV risk. [ABSTRACT FROM PUBLISHER]

Background: Perceived experiences of stigma have been found to be associated with poorer psychosocial outcomes and engagement in risk practices among people who inject drugs. Yet the extent to which people internalize or accept the stigma surrounding their injecting drug use, and whether this is associated with risky injecting practices, is not well known. Objectives: The aim of this study was to assess the extent of internalized stigma among a sample of people who inject drugs in Australia and identify socio-demographic, injecting risk, and mental health correlates. Methods: People who inject drugs were recruited from a needle and syringe program located in Sydney, Australia to complete a brief survey. The survey included measures of internalized stigma, severity of drug dependence, self-esteem, depression, and shared use of injecting equipment. Results: The sample comprised 102 people who inject drugs. Internalized stigma was higher among participants who reported being depressed in the past month, and was also associated with greater severity of drug dependence and diminished self-esteem. There was no relationship between internalized stigma and shared use of needles or other injecting equipment in the past month. Conclusions/Importance: Findings underscore the need for further investigation of internalized stigma among people who inject drugs. In particular, future research should assess the impact of implicit (i.e., subconscious) internalized stigma on mental health. [ABSTRACT FROM AUTHOR]

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]

Although the adverse impacts of health-related stigma are well established, there is growing evidence to suggest that some people reject stigma and become empowered through involvement in education and advocacy. C-een and Heard ( C& H) is a positive speaking programme in Sydney, Australia, using educational presentations by people living with hepatitis C to increase understanding of the illness among health and community workers. This study explored C& H speakers' experiences of and responses to stigma, as well as their motivations to participate in the C& H programme. Semi-structured interviews were conducted with nine C& H positive speakers. Transcripts were analysed using an inductive thematic approach. Experiences of discrimination were common especially in healthcare and were linked to misinformation and negative attitudes towards injecting drug use. Although discriminatory experiences were distressing, many participants reacted with anger and challenged their stigmatised identity, ultimately leading participants to take part in positive speaking. Speakers reported feeling empowered by participation in the C& H programme and by the support received from audience members, peers and programme organisers. Findings highlight the potential benefits of positive speaking programmes for people with chronic illness in relation to overcoming stigma and experiencing empowerment. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aims: Secondary syringe distribution involves the acquisition of injecting equipment by people who inject drugs (PWID) from authorized or 'safe' sources to be distributed to their peers. This article describes the characteristics of those who regularly engage in secondary distribution in Sydney, Australia, and their levels of knowledge about harm reduction. Methods: Data were collected through a cross-sectional study using surveys collected from PWID recruited from 35 pharmacies in metropolitan and regional Sydney. A two-page self-complete survey was distributed by pharmacy staff to each person buying or exchanging needles and syringes. Findings: Of the 602 participants in this study, 114 (18.9%) responded that they regularly engaged in secondary distribution. Despite no significant difference in knowledge about hepatitis C (HCV) transmission, secondary distributors were more likely than non-distributors to tell others specifically about how to get treatment for drug use (40.4% vs 30.2%, p = 0.04), and where to get sterile needles (64.0% vs 45.8%, p = 0.001), alcohol swabs or filters for injecting (41.2% vs 25.9%, p = 0.001). Conclusion: While overall secondary distributors were no more likely to pass on harm reduction information, secondary distributors were significantly more likely to tell others about some specific pieces of information, including where to get ancillary injecting equipment, where to get tested for HCV, and how to get treatment for drug use. [ABSTRACT FROM AUTHOR]