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SOCIO-CULTURAL FACTORS WHICH POTENTIALLY EFFECT THE INSTITUTION OF PREVENTION AND TREATMENT STRATEGIES FOR PREVENTION OF HEPATITIS B IN CHINESE CANADIANS
H Wu, C Yim, A Chan, M Ho, EJ Heathcote
University Health Network, University of Toronto, Toronto, Ontario
Despite the availability of screening for chronic Hepatitis B (CHB) and its complications, and effective treatments, a minority of those chronically infected seek appropriate medical attention. Our aim was to evaluate the baseline knowledge of Chinese patients with Hepatitis B in Toronto, to assess the stigma associated with Hepatitis B and to identify self perceived barriers in order to better serve this population.
Patients with CHB from either two family physicians’ offices or the Toronto Western Liver Clinic were given a written survey in either English or Chinese. The survey collected demographic information, evaluated an individual’s knowledge of Hepatitis B, assessed the stigma they felt about being chronically infected with Hepatitis B and identified self perceived barriers to healthcare
Among the 204 patients enrolled, common misconceptions were that sharing food transmits Hepatitis B (48% correct) and that patients with severe disease are always symptomatic (30% correct). Patients with a better understanding of Hepatitis B were better educated, younger and were being followed at the tertiary care centre (p<0.01 for all). Two thirds of the patients felt stigmatized about having Hepatitis B. 31% of patients felt ashamed about being infected with Hepatitis B and only 47% were willing to discuss their illness with family or friends. Prominent barriers to healthcare were time, inconvenience and language difficulties. Patients followed by family physicians who had extended hours were less likely to cite time (p=0.06) and distance (p=0.05) as barriers.
Patient’s misconception that severe liver disease due to Hepatitis B is symptomatic may factor into unwillingness to spare the time and inconvenience associated with regular medical follow-up. Implementation of programs that increase awareness of the silent progression of CHB and providing culturally responsive clinics, better able to work within patient’s time constraints may improve Chinese patients’ access to healthcare.