The leading causes of hepatitis B stigma are a lack of awareness of the virus and misconceptions about how it is transmitted.A key route of transmission, accounting for most cases in some parts of the world, is from mother to child. This can be prevented by vaccination within 12 hours of birth. Hepatitis B is also spread through sexual contact or through blood, including objects that might have traces of blood, such as needles used for injections, razors and tattoos.
These hurdles have fuelled a growing realization that beating hepatitis B means addressing prevailing mindsets as well as biology. Attempts to counter stigma at multiple levels — political, institutional and personal — are gathering momentum. And important initiatives are connecting individuals with hepatitis B — initially for mutual support, but ultimately to push back against stigma.
Stigma and discrimination by employers, organizations and governments limit the opportunities of people with hepatitis B. Individuals find themselves barred from certain university courses, or unable to find employment. This includes those in the global north, where universities often fail to update discriminatory admissions policies for medical courses, despite anti-discrimination laws being in place.
A lack of awareness and information about hepatitis B are major factors driving stigma — even among people who have been diagnosed. “Some of them are not very well versed in terms of what’s happening within them,” says Tongai Maponga, a clinical researcher studying viral hepatitis and liver cancer at Stellenbosch University in Cape Town, South Africa, and one of Matthews’s collaborators. Part of the problem is that some clinicians fail to effectively communicate with patients, he says.