title: Barriers faced by migrants in accessing healthcare for viral hepatitis infection.
abstract: BACKGROUND
  The morbidity and mortality of hepatitis B virus- and hepatitis C virus-related complications are disproportionately higher in the culturally and linguistically diverse population (CALD) when compared with Australian-born individuals.
  
  
  OBJECTIVE
  This project aims to elucidate the barriers faced by the CALD population in accessing viral hepatitis management.
  
  
  METHODS
  CALD outpatients attending a viral hepatitis clinic in a tertiary teaching hospital were invited to participate in interviews. Questions pertained to: reason for screening for viral hepatitis, barriers to healthcare, perceived community view of viral hepatitis, main source of information of viral hepatitis and suggestions to engage members of CALD to seek healthcare.
  
  
  RESULTS
  The total number of participants was 60. The two major countries of birth included China (40%) and Egypt (17%). In 40% of the cohort, viral hepatitis was identified through screening programmes. Importantly, 37% were diagnosed as a result of complications of hepatitis infection, presenting late in the stage of disease. Forty-five per cent of participants perceived language to be a chief barrier. twenty-two per cent reported cultural barriers to accessing healthcare. Of these, 53% reported fear of discrimination/stigma. The lack of knowledge of available treatments/options was stated as a major obstacle in 40%. The two prevailing recommendations were greater education and awareness (85%) and changes in the health system itself (11%).
  
  
  CONCLUSIONS
  Substantial hurdles identified by participants include cultural differences, language difficulties, cultural beliefs, stigma and misinformation. These data demonstrate the need for the greater dissemination of information in culturally and linguistically appropriate mediums to raise awareness about viral hepatitis, pathogenesis and available treatments.
authors.affiliation: Gastroenterology and Hepatology Department, St George Hospital, Australia. marianne.guirgis@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Guirgis
authors.forename: F
authors.initials: F
authors.lastname: Nusair
authors.forename: Y M
authors.initials: YM
authors.lastname: Bu
authors.forename: K
authors.initials: K
authors.lastname: Yan
authors.forename: A T
authors.initials: AT
authors.lastname: Zekry
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000208:ethnology; D015331:Cohort Studies; D003144:Communication Barriers; D003466:Cultural Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006506:Hepatitis A / Q000208:ethnology / Q000628:therapy; D006509:Hepatitis B / Q000208:ethnology* / Q000628:therapy*; D006526:Hepatitis C / Q000208:ethnology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014171:Transients and Migrants; D055815:Young Adult