Who is Evan?
Evan lives alone in Melbourne, Australia, and has one adult daughter. He describes his ethnic background as ‘Australian’: like both of his parents, Evan was born in Australia. His primary source of income is a social security benefit for people living with a disability.* He has had hepatitis C for over 20 years but currently doesn’t plan on having treatment.
Evan was diagnosed with hepatitis C around the late 1990s. He has had hepatitis C for over 20 years, but doesn’t intend to have treatment at this point, as he doesn’t feel unwell. In the years he has had hepatitis C, Evan has focussed on other health issues, including mental health concerns. Since acquiring hepatitis C, he makes sure never to share injecting equipment with others.
Due to his familiarity with hepatitis C at the time, Evan’s diagnosis didn’t concern him much: ‘I suppose if I was going to pick a word, I would say, [the diagnosis] didn’t appear to faze me much. [I] didn’t think, “I am going to die” or anything, because I knew my mum [had] had it forever, so just thought, “Okay”’.
While Evan has had hepatitis C for over 20 years, he says that he doesn’t have any plans to have treatment, because he doesn’t feel sick and he doesn’t drink alcohol. As he puts it: ‘I am not sick, yeah, I feel all right, and I don’t drink. The only thing I do, I don’t know whether it’s relevant or not, but the alcohol is probably relevant, but the only thing I do is I smoke cigarettes and I will use [heroin] twice a month’.
Over the years Evan has told a few regular doctors about his hepatitis C, and he says they haven’t directly encouraged him to have treatment. He thinks he informed his current doctor about his hepatitis C in an early appointment but they have ‘never discussed’ treatment: ‘[I] probably told him [about the hepatitis C] at the start [… and] I have had blood test[s] for things, because six years ago I got type 2 diabetes, but nothing has ever been said about [hepatitis C treatment …] I don’t think they have ever said, “Do a hep C test” or anything, yeah’.
While living with hepatitis C, Evan has primarily focussed on other health concerns, including some related to his mental health: ‘With my previous doctor […] it was always severe depression and personality disorder, but I think I would argue that one and just say, ‘We all have […some ups] and some downs’. But […] yeah, [the] mental illness thing has been there the whole time’.
*Services Australia Disability Support Pension.
Evan (M, 45, no treatment experience) describes spending around a week in hospital after being diagnosed with hepatitis C. He told his mother about the diagnosis and recalls that she didn’t seem worried about it.
By memory, it was just in the emergency department, so I have gone in really sick, all yellow and admitted as being a drug user, and they have just said that, ‘You have got a hep C flare-up, you just have a hep C flare-up, and we are going to admit you and we are just going to do blood tests and watch your levels and will let you go when you are all right’. So, I ended up there maybe a day over a week or just shy of a week, so like six or eight days […] I told my mum […] Didn’t really seem to faze her, yeah, if I am honest.
Also focussing on injecting, Evan (M, 45, no treatment experience) describes being careful about using new equipment and making sure to keep it separate when injecting with other people.
Well, everything has to be my own equipment, everything has to be brand new, like, I won’t, yeah, I won’t share a spoon, you know, [or have] two people drawing out together, or any of that sort of stuff. I won’t do anything like that, and [I] sort of got this from my mum, because I don’t know, maybe you learn […] Why do we put two sugars in coffee? Because we saw adults do it, so we think two sugars have to go in a coffee.
Evan (M, 45, no treatment experience) explains that while he is unsure whether he agrees with his mental health diagnoses, his mental health is the focus on his meetings with his doctor. This means that, for him, hepatitis C is one of a number of health issues needing attention.
Yeah, mental health […] Yeah, it was always severe depression and personality disorder, but I think I would argue that one and just say, ‘We all have […some ups] and some downs’. But let’s say, it’s usually been about that […] I remember when I was 23 or 24 […] it seemed to be mostly what we were dealing with every time I’d go see him – apart from doing my prescribing, when it needed to be done.