This concept analysis examines hepatitis C virus (HCV) stigma among women and defines the factors that shape it, focusing on its antecedents, core attributes, and consequences. Drawing on 33 published articles, the authors identify limited knowledge about HCV, fear of diagnosis, and disclosure of HCV status as the main antecedents to stigma. They describe the defining attributes of HCV stigma among women as decreased self-worth, negative stereotyping, and fear of transmission, especially in relation to pregnancy, parenting, and caregiving. The analysis emphasizes that women’s experience of HCV stigma is distinct because it is closely tied to identity, motherhood, relationships, and concerns about transmitting infection to children or partners.

The paper also highlights the consequences of stigma, showing that it can damage intimate, family, and healthcare relationships while reducing healthcare access and health-seeking behavior. Women reported rejection, social isolation, altered sexual relationships, fear of disclosure, and negative or discriminatory experiences in clinical settings, all of which could delay care for themselves and even their children. The authors argue that pregnancy and the prenatal period may offer especially important opportunities for supportive, destigmatizing care, and they call for more research on stigma layering, LGBTQIA2S+ experiences, and how stigma persists even in the direct-acting antiviral era. Overall, the analysis concludes that a better understanding of HCV stigma among women can help clinicians, educators, and support workers design more responsive and less stigmatizing care.

Reference: Masterman C, Mendlowitz AB, Capraru C, et al. An evolutionary concept analysis: stigma among women living with hepatitis C. BMC Public Health. 2024 Sep 28;24(1):2660. doi:10.1186/s12889-024-20131-6. PMID: 39342214; PMCID: PMC11439273.

This cross-sectional study used data from the Rural Opioid Initiative to examine hepatitis C virus (HCV) testing and treatment among 2705 adults who use drugs in 10 rural US communities, focusing on differences by recent substance use pattern. Most participants reported using both opioids and stimulants. Smaller groups reported opioid-only use, stimulant-only use, or use of other drugs. HCV testing history varied significantly by substance use pattern: participants who reported opioid-only use were least likely to say they had ever been tested for HCV, while those reporting other drug use had the highest testing rates. Across the HCV continuum of care, completion dropped off at each step, and overall treatment uptake was low.

Among participants who said they had been told they had HCV, only 12% reported receiving HCV medication. In adjusted analyses, people who reported using both opioids and stimulants were significantly less likely to report HCV treatment than those reporting other drug use. Opioid-only and stimulant-only groups did not differ significantly from the reference group. The authors conclude that major service gaps remain in rural HCV care, especially for people using both opioids and stimulants. They suggest that barriers may include limited access, stigma, provider practices, competing survival priorities, and lingering policy effects such as Medicaid sobriety restrictions. Ultimately, they call for more targeted efforts to improve screening, linkage to care, and treatment access in rural people who use drugs.

Reference: Estadt AT, Kline D, Miller WC, et al. Differences in hepatitis C virus (HCV) testing and treatment by opioid, stimulant, and polysubstance use among people who use drugs in rural U.S. communities. Harm Reduct J. 2024 Nov 29;21(1):214. doi: 10.1186/s12954-024-01131-6. PMID: 39614319; PMCID: PMC11606200.

Hepatitis C virus (HCV) remains a major global public health challenge. However, it is now a curable infection thanks to direct-acting antivirals (DAAs), which can achieve cure rates above 95% with short, well-tolerated treatment courses. The article explains that HCV is transmitted primarily through blood exposure, especially and unsafe healthcare practices. Chronic infection can remain silent for years before leading to cirrhosis, liver cancer, and extrahepatic complications. Because of these risks, elimination efforts depend not only on effective treatment. They also require better screening, simpler testing and treatment pathways, decentralized care, harm reduction services, and integrated programs that reach high-risk and marginalized populations.

Globally, progress toward the World Health Organization’s 2030 elimination goals has been uneven. Some countries have made major gains through strong national commitment, broad screening, lower-cost treatment access, and innovative care models. But many regions still face major barriers such as underdiagnosis, limited infrastructure, stigma, cost, and inadequate access to care. In the United States, mortality has declined, while new infections continue to rise, especially among people who inject drugs. Many people remain undiagnosed or untreated because of fragmented screening, treatment restrictions, and inequities in access. The overall outlook is hopeful: the article concludes that eliminating HCV is achievable, but only with stronger national investment, policy support, and sustained public health action.

Reference: Fleurence RL, Alter HJ, Collins FS, Ward JW. Global Elimination of Hepatitis C Virus. Annu Rev Med. 2025 Jan;76(1):29-41. doi: 10.1146/annurev-med-050223-111239. Epub 2025 Jan 16. PMID: 39485830.