Controversies in and challenges to our understanding of hepatitis C

Table 1 Factors impeding our understanding of HCV issues world-wide

Societal attitudes to the infected community

Injecting drug use is seen as a moral weakness and thus not needing to be addressed

Infection is the fault of the infected individual

Why should society expend money on those who undertake illicit activities?

Societal attitudes to prisoners

Prisoners are imprisoned to be punished

Prison sentences are usually relatively brief so the prisoner can wait for assessment and treatment

Drugs are not available in prison so there is no need for prevention measures against HCV

Societal attitudes affect Health care worker attitudes

More discrimination against HCV infected individuals occurs in health care settings than in the general community

Patients unwilling to disclose (their condition?) for fear of discrimination leading to poor care

All these issues decrease open disclosure and impair a full understanding of HCV transmission.