Peta’s Story

Name: Peta

Gender: Female

Age: 48

Who is Peta?

Peta lives with her dog in Melbourne, Australia. She describes her ethnic background as ‘Australian’: like both of her parents, Peta was born in Australia. Her primary source of income is a social security benefit for people living with a disability.* As Peta explains, because she injects drugs alone, hepatitis C isn’t at the ‘forefront of [her] head’, but she feels it ‘would be silly’ for her not to have a test for it in the future.

Brief Outline:

Peta hasn’t been diagnosed with hepatitis C and doesn’t think about it a lot. She has had tests at different health services over the years but doesn’t recall receiving her results. She explains that concerns about stigma put her off talking about her drug injecting with her doctor and other health professionals. She says that she will get a hepatitis C test soon.

Peta's Story:

Peta has never been diagnosed with hepatitis C and while she has never actively sought a test for it, over the years she has been tested at various healthcare services. For example, she explains that she had a hepatitis C test at an inpatient withdrawal management service, or ‘detox’, and attended a related class there: ‘I think one of the classes we had in the detox was about just blood-borne viruses and things like that, but I never paid any bloody attention and they didn’t really push you’.

While Peta recalls having a hepatitis C test while staying in the detox service, she can’t remember the details as the staff didn’t explain her results: ‘I think they did [a] blood test and checked it and then left it at that. They didn’t even get back to me and tell me that I didn’t have it, you know what I mean’.

Stigma has had a big impact on Peta. Her contact with healthcare services has been tainted by bad experiences with staff criticising her for consuming drugs: ‘Yeah, previous doctors have said, “Why the hell would you want to do that, it’s disgusting, it’s bad for you, you know, I can’t believe you are doing it”. Like, you know, [they have] really judged me about it’.

According to Peta, having healthcare professionals focus solely on her drug consumption has limited the quality of their advice and her trust in them overall: ‘So […] I have just dismissed [doctors] because every time I went in there for some issue, they all based it back to “it’s because you are using drugs”. You know, every health issue I had, they said it was because I was injecting drugs’.

These days Peta has a doctor she sees regularly, but says that after her experiences of stigma over the years, she doesn’t feel comfortable being completely open about her current drug consumption. This means she isn’t comfortable asking her doctor about issues related to injecting. As she puts it, ‘No, no [I don’t speak to her about injecting drugs]. When I first went to her, I mentioned it and she just said, “Well, we need to do some blood tests”, [but] I don’t know if she did hep C or not […] I said that I was an ex-user because I didn’t want to be judged, because I find there is a big stigma around it still and I don’t like being judged because of it […] That’s just the way it is at the moment, you know. It is what it is, you know, but everyone thinks you are filthy [for injecting drugs]’.

Peta says that it ‘would be silly’ for her not to have a test for hepatitis C soon, but because she injects drugs alone, it isn’t at the ‘forefront of [her] head’.

*Services Australia Disability Support Pension.

Hepatitis C Quick Reference

While the new direct-acting antiviral (DAA) treatment for hepatitis C is generally straight forward, the personal experiences of people affected by it can be more complex. Below are a few key points about testing, treatment and health after cure.

Acquiring hepatitis C

Hepatitis C is a ‘blood-borne virus’. This means it is acquired through blood-to-blood contact. This can happen in several different ways. In some countries such as Australia, hepatitis C is commonly acquired through sharing injecting equipment. In other countries, hepatitis C is more commonly acquired through medical procedures or forms of skin penetration such as tattooing, body piercing or acupuncture, when unsterilised equipment has been used.

Hepatitis C testing

Two tests are used to diagnose hepatitis C. The first is an ‘antibody test’. This is used to identify exposure to hepatitis C. A positive antibody test shows that exposure has occurred, but not whether hepatitis C is still in the body. The presence of hepatitis C is determined with a PCR test. A PCR test looks for hepatitis C in the bloodstream by detecting the genetic material specific to the virus. A negative PCR test means the body has ‘cleared’ hepatitis C without treatment. A positive PCR test means hepatitis C is still present and medical advice is needed to discuss the possibility of future tests and treatment.

Treatment

The current form of hepatitis C treatment is called direct-acting antiviral (DAA) treatment. It is taken in tablet form, with around 95% of people cured on completion. This treatment replaced the old interferon-based treatment. The new treatment was a significant improvement for people with hepatitis C because it is relatively short (cure usually results within eight to 12 weeks) and has minimal side effects. The old treatment by comparison was much longer, less likely to result in cure and had many debilitating side effects. Because the old treatment was unreliable and debilitating, many people with hepatitis C chose not to have it, and instead waited for the development of better treatment. Many of these people have now been cured using the new treatment.

After treatment

After hepatitis C cure it is still possible to test positive for hepatitis C antibodies (see the two tests described above). This is because the antibody test only determines whether hepatitis C has ever been in the body. Only a PCR test can determine whether hepatitis C is still active in the body. Importantly, it is possible to acquire hepatitis again after cure. There are no limits to how many times testing or treatment for hepatitis C can be accessed in Australia. This means that treatment is always an option even for people who have had it in the past.