Disclosure of hepatitis B and reduced access to health care due to stigma: an exploratory study with Chinese people living with hepatitis B in Australia.

Decisions of whether to disclose a stigmatised health condition are complex and have ramifications for affected populations; however, there is very limited knowledge of hepatitis B-related disclosure. This study explored disclosure of hepatitis B, concerns around disclosure, and whether these concerns are associated with other outcomes among Chinese people living with hepatitis B. Surveys with 65 Chinese people living with hepatitis B in Australia measured disclosure of hepatitis B, concerns around disclosure, reduced access to care due to stigma, perceived and experienced stigma, negative treatment by health workers, frequency of health check-ups, and personal wellbeing. Disclosure of hepatitis B to family and sexual partners was high. While 66% of participants had disclosed their status to their doctor, only 19% reported disclosing to other health workers. Concerns around disclosure centred on whether they would be isolated by others (48%) and whether they would be a burden to family or an employer (20%). Correlations revealed that those who reported greater perceived and experienced hepatitis B-related stigma had more concerns around disclosure and poorer personal wellbeing. Negative treatment by health workers was associated with greater perceived and experienced hepatitis B-related stigma, lower frequency of check-ups, and reduced access to care. Participants who reported a greater frequency of check-ups reported higher personal wellbeing. Findings highlight the need to support people living with hepatitis B to build community connectedness to mitigate the negative impacts of stigma, as well as among the broader community to address stigmatising attitudes towards hepatitis B. Supporting people living with hepatitis B and building community connectedness may help mitigate the wellbeing impacts of stigma and promote sustained engagement with health care services.