Disclosing Hepatitis

C Infection Within
Everyday Contexts Journal of Health Psychology
Copyright © 2010 SAGE Publications
Los Angeles, London, New Delhi,
Implications for Accessing Singapore and Washington DC
www.sagepublications.com
Support and Healthcare Vol 15(6) 811–818
DOI: 10.1177/1359105310370499

MA X H O P W O O D Abstract
University of New South Wales, Australia
In this paper the authors quantify
TAM O N A K A M U R A
hepatitis C disclosure outcomes across
University of Newcastle, Australia
social contexts and identify the factors
CAR LA T R E L O A R
University of New South Wales, Australia associated with widespread disclosure
of infection. In a cross-sectional
survey of people with hepatitis C
(N = 504) more than half reported
receiving a bad reaction from
someone following disclosure.
Unauthorized disclosure occurred, and
many participants had been pressured
into disclosing their infection. The
factors associated with widespread
disclosure were: education level;
knowing other people with hepatitis
C; feeling fatigued; receiving
disclosure advice; and experiencing
unauthorized disclosure. Bad reactions
following disclosure are common and
may impede health-seeking behaviour
including uptake of hepatitis C
treatment.

A C K N O W L E D G E M E N T S . The authors are grateful to all the participants

who took part in the study. The authors would also like to thank Dr Erica
Southgate, Dr June Crawford, Dr Limin Mao, Dr Clive Aspin, the Hepatitis
C Council of New South Wales, the Resource and Education Program for
Injecting Drug Users (REPIDU) and HepLink, the Australian national body
of professional hepatitis C workers.

COMPETING INTERESTS: None declared.

Keywords
ADDRESS. Correspondence should be directed to:
D R M A X H O P W O O D , National Centre in HIV Social Research, Level 2
■ disclosure
Webster Building, The University of New South Wales, Sydney 2052, ■ discrimination
Australia. [Tel. +612 9385 6436; Fax +612 9385 6455; email: ■ healthcare
m.hopwood@unsw.edu.au] ■ hepatitis C

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JOURNAL OF HEALTH PSYCHOLOGY 15(6)
PAST research has demonstrated the beneficial
psychological health effects of disclosure in relation
to living with chronic illness (e.g. Pennebaker,
1995). Disclosing illness assists affected people to
accept a new diagnosis and to cope emotionally
with a changing set of personal health circum-
stances. Disclosure also facilitates the acquisition of
support from family and friendship networks and
health-related services. Conversely, disclosing a
stigmatized illness or condition potentially adds to
the burden of disease. For example, research
describes how disclosure of HIV infection can be an
acute and recurrent stressor for affected people
(Ariss, 1997; Holt et al., 1998; Malcolm et al.,
1998). Similarly, disclosure of hepatitis C infection
has provoked discriminatory responses which gen-
erate a variety of undesirable effects (Crofts, Louie,
& Loff, 1997). Discriminatory outcomes from
hepatitis C disclosure can increase affected individ-
uals’ ‘sense of despair and absolute contamination’
at being hepatitis C positive (Fraser & Treloar,
2006, p. 100). Affected people may become more
reckless and increase their risk-taking behaviour
(Hepworth & Krug, 1999). Additionally, fear of
future disclosure can compromise health and qual-
ity of life by inhibiting people’s access to support,
their utilization of health services and their uptake
of hepatitis C treatments (Hopwood & Treloar,
2008; Hopwood, Treloar, & Redsull, 2006). Past
research highlights that disclosure of a stigmatized
illness or condition is a salient issue for health psy-
chology. In this article, the authors draw on a study
of living with hepatitis C to highlight some dynam-
ics of disclosure and its health impacts.
Hepatitis C is a highly stigmatized infection and
there is a strong association between disclosure of
hepatitis C and discrimination (Anti-discrimination
Board of New South Wales [ADBNSW], 2001;
National Centre in HIV Social Research, 2001).
Over recent years, a growing scholarly literature
has acknowledged the detrimental impact of hepati-
tis C-related stigma and discrimination on preven-
tion of transmission, treatment uptake and quality
of life for affected people (e.g. Golden, Conroy,
O’Dwyer, Golden, & Hardouine, 2006; Hopwood,
Treloar, & Bryant, 2006; Paterson, Backmund,
Hirsch, & Yim, 2007). Hepatitis C-related stigmati-
zation and discrimination arises from the widespread
confounding of injecting drug use with hepatitis C,
and poor levels of knowledge about the viral
infection within the health sector and the broader
community (ADBNSW, 2001). Some outcomes of
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disclosure are described in a seminal qualitative
study of hepatitis C-related discrimination by Crofts
et al. (1997). They found that people who disclosed
their hepatitis C infection often experienced ‘hys-
terical responses’ (p. 90) and suffered negative con-
sequences across a range of settings. Some
healthcare professionals implemented overly rigor-
ous infection control procedures or neglected their
patients with hepatitis C. Within domestic settings,
people who had disclosed their infection experi-
enced offensive phone calls, graffiti and verbal
harassment from friends, neighbours or flatmates.
Within occupational settings, some employees who
disclosed their hepatitis C infection experienced
isolation at work or had their employment termi-
nated. An association between disclosure and
discriminatory outcomes has been supported by
subsequent research (e.g. Owens, 2008; Platt &
Gifford, 2003; Treloar & Hopwood, 2004).
Few studies have specifically investigated the
dynamics of hepatitis C disclosure. However, some
report that affected people will usually disclose
hepatitis C infection to their physician (Schafer,
Scheurlen, Felten, & Kraus, 2005), and often to their
peers (Gyarmathy, Neaigus, Ujhelyi, Szabo, & Racz,
2006). Gender differences have been identified, with
women more likely than men to disclose their infec-
tion to partners, children and other family members
(Dunne & Quayle, 2002). Most partners of women
who disclose are reportedly supportive, regardless of
whether the partner has hepatitis C or not (Gifford,
O’Brien, Bammer, Bamwell, & Stoove, 2003). In a
study of hepatitis C treatment experiences, some
participants had endured treatment in silence, with-
out disclosing to their partner, family or friends
(Hopwood et al., 2006). Others had devised disclo-
sure strategies—such as deploying euphemisms—in
order to circumvent negative reactions and to
account for visible treatment-related side effects.
Nonetheless, fear of the outcomes from disclosing
discouraged some people from commencing treat-
ment for hepatitis C infection. This is a significant
concern, given that treatment is effective for a
majority of people with hepatitis C. Renewed efforts
to encourage people to commence treatment in
Australia has seen only a modest increase in the
number of people accessing treatment (National
Centre in HIV Epidemiology and Clinical Research
[NCHECR], 2008). Given the association between
disclosure and discrimination, a desire to avoid dis-
closure of hepatitis C infection may be a barrier to
hepatitis C treatment uptake.
 HOPWOOD ET AL.: DISCLOSING HEPATITIS C INFECTION WITHIN EVERYDAY CONTEXTS
Despite a burgeoning interest in the dynamics of
hepatitis C disclosure, estimates of the proportion
of people who experience negative outcomes from
disclosing do not appear in the literature. Similarly,
little attention has been paid to exploring who prac-
tises widespread disclosure of hepatitis C infection
and what happens with this information. The
authors investigate these issues in this article by
presenting data from a study of people with hepati-
tis C that asked: (1) what proportion of people expe-
rience discrimination as an outcome of disclosing
their hepatitis C; (2) who reacts negatively to
hepatitis C disclosure; and (3) what factors predict
whether or not an individual engages in widespread
disclosure of hepatitis C?
Method
Participants and procedure
To participate in the study, people had to have
hepatitis C infection and be living in New South
Wales, Australia. Using a convenience sampling
frame, participants were recruited via an advertise-
ment in the March and June 2001 editions of The
Hep C Review, a quarterly magazine published by
the Hepatitis C Council of New South Wales, and
from eligible callers to the Council’s telephone
information and helpline. A reply-paid question-
naire was inserted in these two editions of the mag-
azine, as well as being sent to interested callers.
From this recruitment strategy, 450 people with
self-reported hepatitis C infection responded during
2001 and 2002. To increase the number of current
injecting drug users in the sample, 54 additional
participants were recruited by approaching clients
at a needle and syringe programme (NSP) in central
Sydney. No financial incentives to participate were
extended. All participants completed an anony-
mous, short questionnaire containing items that
focused on their experience of hepatitis C diagno-
sis, disclosure and discrimination. The question-
naire took approximately 15 minutes to complete.
The study had the approval of the University of
New South Wales’ Human Research Ethics
Committee and the Ethics Review Committee of the
Central Sydney Area Health Service.
Analysis
One item in the questionnaire was used as a scale to
measure participants’ level of disclosure: ‘Who have
you told that you have hep C?’ The response
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categories for this item were partner, family, children,
doctor, other healthcare workers, casual sexual part-
ners, flatmates, friends, boss and workmates. A dis-
closure scale was constructed from participants’
responses to this item. The scale ranged from 0 to 8
where 0 indicated that participants disclosed to no
one and 8 represented that participants disclosed to
eight different categories of people. The median of
the scale in the sample was 4.0. Less than a half of
the sample (44.0%, n = 222) had values less than the
median and 23.0% (n = 116) had a value equal to the
median. A reliability analysis revealed that the dis-
closure scale has a Cronbach alpha of .65.
Although this scale does not indicate the absolute
number of people to whom each participant has dis-
closed, it does capture the breadth of disclosure.
Throughout this article, the phrase ‘disclosing more
widely’ and ‘wider disclosure’ is used to refer to
those people who scored higher on this scale com-
pared to those who scored lower. A series of uni-
variate analyses of variance (ANOVA) examined
associations between the disclosure scale and other
variables thought to influence disclosure behaviour.
Where there were differences among three or more
means, orthogonal post-hoc contrast testing was
performed. A multiple linear regression analysis
was conducted to determine variables predicting
wider disclosure, taking other variables into
account. A reduced model was derived using back-
ward elimination to identify variables indepen-
dently associated with wider disclosure. A type 1
error rate of .05 was used to determine statistical
significance.
Results
Participant characteristics
In all, 504 participants were recruited to the study
(Table 1). The age of participants ranged from 18 to
77 years, with a mean age of 42 years. There were
approximately equal numbers of men and women.
Most participants (57.5%) cited injecting drug use
as the source of their hepatitis C infection and over
a quarter (27.4%) had injected drugs in the month
prior to completing the questionnaire. Participants
in this study were mainly older, former injecting
drug users. They were not highly educated and
existed on low incomes, and most had been living
with hepatitis C for many years.
A comparison of sample characteristics of the
groups obtained via the two recruitment strategies
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JOURNAL OF HEALTH PSYCHOLOGY 15(6)

Table 1. Characteristics of sample (N = 504)a report feeling tired from their infection (36.0 vs
60.0%, χ2 = 7.3, df = 1, p < .01). On all other dimen-
Characteristic n %
sions these two groups did not differ.
Gender (n = 499)
Male 254 50.4 Patterns of hepatitis C disclosure
Female 244 48.4 Approximately three-quarters of participants had
Transgender 1 0.2 disclosed to a regular partner and to their family
Age (n = 472) (Table 2). Similarly, most participants had disclosed
18–30 years 65 12.9 their infection to their doctor (76.0%) or another
31–50 years 334 66.3 healthcare worker (65.7%) and friends (69.0%). In
51–77 years 73 14.5 contrast, few people had disclosed to their boss
Education (n = 495) (16.5%) or workmates (17.3%). Participants were
Up to and including Year 12 269 53.4
asked who had ‘reacted badly’ to their disclosure of
Diploma/degree 183 36.2
Postgraduate 43 8.5
hepatitis C (Table 2). In all, 52.0% of participants
Income per year (n = 448) (n = 262) reported that someone had reacted badly.
< $10,000 184 36.5 Bad reactions were reported from a range of people
$10,001–$20,000 92 18.3 including family (22.6%, n = 81), friends (19.5%,
$20,001–$30,000 58 11.5 n = 68), partners (17.1%, n = 63), healthcare workers
$30,001–$40,000 29 5.8 (16.3%, n = 54) and doctors (11.5%, n = 44). One in
$40,001–$50,000 33 6.5 six women (16.6%, n = 31) reported that their part-
$50,001–$60,000 30 6.0 ner had reacted badly following disclosure. In addi-
Over $60,000 22 4.4 tion, 37.5% of participants (n = 189) said that they
Self-reported source of infection (n = 494)
regretted telling someone about their infection.
Injecting drug use 290 57.5
Medical blood products 74 14.7
Over a third of participants (36.7%, n = 185)
Tattooing 20 4.0 reported that information about their hepatitis C
Sex 15 3.0 infection had been told to someone else without
Body piercing 5 1.0 their permission. The source of these unauthorized
Other 44 8.7 disclosures included friends (15.9%, n = 80) and
Multiple responses 46 9.1 doctor or other healthcare worker (13.5%, n = 68).
Self-reported time since infection (n = 490) Finally, 11.9% of all participants reported that they
Within the last year 12 2.4 had been pressured into disclosing their infection
Between 1and 5 years ago 67 13.3 and of these 60 people, 51.7% (n = 31) reported that
Between 6 and 10 years ago 82 16.3
a healthcare worker had pressured them into dis-
Between 11 and 20 years ago 199 39.5
Over 20 years ago 130 25.8
closing and 28.3% (n = 17) reported that a govern-
Injected in the last month (n = 496) ment department had pressured them into disclosing
Yes 138 27.4 their hepatitis C infection.
No 358 71.0 Of the participants, 55.2% (n = 278) reported that
they had disclosed their infection to at least four cat-
a
Proportions do not add to 100% due to missing data egories of people and 32.1% (n = 162) had disclosed
to at least five categories of people. Participants with
a higher level of education (i.e. post-school diploma
revealed no significant differences. Similarly, a or university degree) disclosed to a wider range of
comparison of current injecting drug users recruited people than those with less education (i.e. high
via the two strategies revealed minor differences: school matriculation level/Year 12 or less) (t228.9 =
compared with current injecting drug users –3.0, p < .05). Participants who reported that they
recruited via the Hepatitis C Council of New South had been refused medical treatment because they
Wales, current injecting drug users who attended had hepatitis C and those who were not sure whether
the NSP were more likely to have injected the they had been refused medical treatment, had dis-
methamphetamine ‘ecstasy’ (63.3 vs 0.0%, χ2 = closed more widely than those who reported they
68.6, df = 1, p < .001), were less likely to have ever had not been refused medical treatment (t491 = –2.0,
received treatment for hepatitis C (5.9 vs 22.1%, p < .05). Participants who knew six or more people
χ2 = 6.2, df = 1, p < .05) and were less likely to with hepatitis C disclosed their own infection more

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 HOPWOOD ET AL.: DISCLOSING HEPATITIS C INFECTION WITHIN EVERYDAY CONTEXTS

Table 2. Disclosure of hepatitis C infection and subsequent ‘bad’ reactions (N = 504)

Disclosure ‘Reacted badly’

a
Disclosed to: n % n %b

Casual sex partner 96 19.0 26 27.1

Family (i.e. parents/siblings) 359 71.2 81 22.6
Friend 348 69.0 68 19.5
Flatmate 90 17.9 17 18.9
Partner 369 73.2 63 17.1
Boss 83 16.5 14 16.9
Other healthcare worker(s) 331 65.7 54 16.3
Workmate 87 17.3 12 13.8
Doctor 383 76.0 44 11.5
Children 143 28.4 14 9.8
a
Percentage of total sample.
b
Of those who had disclosed, the percentage of people who had experienced a bad reaction.

widely than those who knew less than six people Table 3. Reduced model for disclosure of hepatitis C
with hepatitis C (t234.4 = –4.9, p < .01). Participants infection
who reported that in the last month having hepatitis
Variable Unstandardized β SE Sig.
C had affected them, made them want to get healthy,
stopped them from doing the things they like, or Level of education 0.38 0.12 < .01
made them feel very tired, had disclosed more Number of hep C 0.40 0.07 < .01
widely than those who did not report these effects. positive people
Participants who reported that they regretted dis- participant knows
closing their hepatitis C infection to someone, or Feeling tired due 0.36 0.16 < .05
to hep C over the
that their hepatitis C infection had been told to
past month
someone else without their permission, or that they
Advised to tell no –0.92 0.24 < .01
had been pressured into disclosing their hepatitis C one or only close
infection, had disclosed more widely than those who family of hep C
did not report these effects and events. Finally, par- Hep C infection 0.39 0.17 < .05
ticipants who were advised at the time of diagnosis disclosed without
to tell no one or only their close family about their permission
infection disclosed less widely than those who did
not report receiving this advice.
Those participants who at the time of their diagno-
Predicting disclosure of hepatitis C sis were advised to tell no one or only their close
Variables assessed in the disclosure scale were sub- family, would disclose their hepatitis C infection
sequently tested in a multiple linear regression to less widely than those who did not receive this
determine the unique association of these variables advice. Finally, participants who reported that their
with disclosure. Variables in the reduced model infection was disclosed by others without their per-
appear in Table 3. The final reduced regression mission reported disclosing more widely.
model contained five variables that predicted wider
disclosure when other variables were also taken into
account. Higher-educated participants reported Discussion
wider disclosure. The more people with hepatitis C
that participants knew, the more widely they dis- The above findings are based on an analysis of self-
closed. Participants who reported feeling very tired report data obtained from a cross-sectional study
over the last month as a result of having hepatitis C which used a convenience sampling frame. As such,
(i.e. being symptomatic) reported wider disclosure. there are limits to the representativeness of the sample

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JOURNAL OF HEALTH PSYCHOLOGY 15(6)
and the generalizability of the findings. It is evident
from a comparison with known attributes of
Australians diagnosed with hepatitis C that the
study sample was not representative (Australian
National Council on AIDS, Hepatitis C and Related
Diseases, 2002). Around 58% of the study sample
had acquired their infection from injecting com-
pared with 83% nationally, and males comprised
about half of the study’s sample, whereas approxi-
mately 65% of all hepatitis C diagnoses in Australia
are among males. Issues pertaining to disclosure are
also likely to vary according to one’s ethnic and cul-
tural background. The findings of this study do not
reflect the specificity of disclosure dynamics within
differing ethnic or cultural contexts. Finally, while
the data was collected during 2001 and 2002, there
is no evidence of significant change within the
intervening years which would affect these results.
Although the above limitations of this study are
acknowledged, the sample was similar on the
dimensions of age, education and income to the
Australian national profile of people diagnosed with
hepatitis C. The decision to use a convenience sam-
pling frame to collect self-report data enabled the
researchers to identify salient issues for this group
of affected people, some of which are likely to be
generalizable.
The main finding of this study is that most people
disclose hepatitis C infection at some point following
their diagnosis, and it is not uncommon to receive a
bad reaction. We did not define ‘bad reaction’ for
participants; instead we assumed a lay understanding
of the phrase. The implications of this finding are
worrying, given that over 200,000 Australians (or
more than 1% of the population) have chronic hepati-
tis C infection and approximately 10,000 new infec-
tions occur each year (NCHECR, 2008). In other
contexts, people who are diagnosed with chronic ill-
nesses rarely endure negative outcomes from dis-
closing their condition, especially from health
professionals. Instead, following disclosure of illness
there is an expectation of empathy and perhaps sup-
port. However, following disclosure of hepatitis C
infection many people can expect to encounter dis-
approval. This study’s findings regarding bad reac-
tions to hepatitis C disclosure corroborate findings of
the qualitative work by Crofts et al. (1997) and the
findings of the Anti-Discrimination Board of New
South Wales’ (2001) enquiry.
In this present study about a half of participants
indicated that they had disclosed their infection to
at least four categories of people, and about a third
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had disclosed more widely. Families, loved ones,
casual partners, doctors and other healthcare work-
ers were the major sources of bad reactions to
hepatitis C disclosure. In the context of close per-
sonal relationships, which are usually one’s pri-
mary source of support, receiving any bad reaction
adds to the burden of illness. On a positive note,
our results are similar to Gifford et al.’s (2003)
finding that a majority of partners of women with
hepatitis C were reported to be supportive follow-
ing disclosure.
A substantial minority of participants reported
that their doctor or other healthcare worker had
reacted badly following disclosure of hepatitis C.
This is a concern as, throughout the developed
world, prevention of infection and the promotion of
interferon-based treatments are central to efforts
aimed at curbing future morbidity, mortality and
healthcare costs associated with hepatitis C-related
liver disease. Hepatitis C-related stigma in the
healthcare sector decreases the likelihood that
affected people will access healthcare to address
hepatitis C symptoms or to commence interferon-
based treatments to eradicate infection (Hopwood et
al., 2006). One approach to ameliorate health-
related stigma and discrimination is to improve
healthcare workers’ education and understanding of
hepatitis C infection.
Over one-third of participants regretted telling
someone about their infection, in this study.
Healthcare workers were reported to have spread
personal health information without participants’
permission and to have pressured participants into
disclosing their hepatitis C infection. Unauthorized
and coerced disclosures are unethical and increase
the likelihood that patients will lose trust in health-
care providers. In previous studies (e.g. Serovich,
2001), breaches of confidentiality have influenced
participants’ disclosure patterns. In the present
study, participants who had their status disclosed
without their permission disclosed more widely,
perhaps in response to requests to confirm leaked
information. Government departments also report-
edly pressured some participants to disclose their
infection. Such findings highlight a need for people
to be better informed of their rights regarding dis-
closure of personal health information to health pro-
fessionals and bureaucracies.
The factors associated with widespread disclo-
sure of hepatitis C were level of education, the
presence of fatigue (a common symptom of hepatitis
C), advice regarding disclosure, unauthorized
 HOPWOOD ET AL.: DISCLOSING HEPATITIS C INFECTION WITHIN EVERYDAY CONTEXTS
disclosure and the number of other people with
hepatitis C that a participant knew. Our finding
that higher educated participants disclosed more
widely is supported by previous disclosure
research (e.g. Kennamer, Honnold, Bradford, &
Hendricks, 2000). This occurs because, in general,
better-educated people hold broader perspectives
on life; they often have wider and more diverse
social networks and are financially more secure
(Kennamer et al., 2000). Better-educated people in
our study were more likely to disclose because
they were better informed about their infection,
and may have mixed with similarly educated peo-
ple who were less susceptible to fears concerning
contagiousness, and who invested less in the neg-
ative stereotypes that surround hepatitis C and
people who inject.
Similarly, those participants who reported tired-
ness due to their hepatitis C infection over the
month prior to completing the questionnaire dis-
closed more widely. If fatigue becomes a constant
in one’s life, it is likely that disclosure of hepatitis
C becomes necessary to account for it. This finding
concurs with a theory of disease progression
derived from the field of HIV (Holt et al., 1998;
Serovich, 2001), which suggests that disclosure of
disease becomes necessary in a wider variety of
contexts as symptoms of the disease become evi-
dent to more people. If participants were advised
by their doctor or other healthcare worker at the
time of their diagnosis to either tell no one about
their infection or only their close family, they dis-
closed less widely. Finally, participants disclosed
their infection more widely if they reported know-
ing many other people with hepatitis C. Having fre-
quent contact with other similarly affected people
facilitates the sharing of knowledge and personal
experience that contribute to the acceptance and
normalization of one’s infection. This homophilic
principle (McPherson, Smith-Lovin, & Cook,
2001) has implications for disclosure behaviour. If
one is immersed within networks of other people
with hepatitis C, disclosing widely is easier and can
assist self-acceptance and increase support oppor-
tunities through building further connections with
people in similar circumstances (Holt et al., 1998).
Disclosure of hepatitis C presents a significant
risk to the psychological and physical health of
individuals. A high priority should be given to
exploring the role of disclosure in preventing
hepatitis C transmission, in increasing treatment
uptake and in managing the impact of the epidemic.
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Author biographies
MAX HOPWOOD, PhD, is a social psychologist and
Research Fellow at the NCHSR. His research
interests include the socio-cultural dynamics of
injecting and other illicit drug use, bloodborne
virus transmission and quality of life for people
living with hepatitis C.
TAMO NAKAMURA, PhD, is a psychologist with
experience in HIV/AIDS research. Currently
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‘serosorting’ gay men. Culture, Health and Sexuality,
10, 601–610.
Paterson B. L., Backmund, M., Hirsch, G., & Yim, C.
(2007). The depiction of stigmatization in research
about hepatitis C. [Review] International Journal of
Drug Policy, 18, 364–373.
Pennebaker, J. W. (1995). Emotion, disclosure and
health. Washington, DC: American Psychological
Association.
Platt, M. W., & Gifford, S. M. (2003). Promoting health
through promoting work: The dilemmas of disclosure in
the workplace for employers and for Australian women
living with hepatitis C. Health Promotion Journal of
Australia, 14, 180–186.
Schafer, A., Scheurlen, M., Felten, M., & Kraus, M. R.
(2005). Physician-patient relationship and disclosure
behaviour in chronic hepatitis C in a group of German
outpatients. European Journal of Gastroenterology and
Hepatology, 17, 1387–1394.
Serovich, J. M. (2001). A test of two HIV disclosure theo-
ries. AIDS Education and Prevention, 13, 355–364.
Treloar, C., & Hopwood, M. (2004). Infection control in
the context of hepatitis C disclosure: Implications for
education of healthcare professionals. Education for
Health, 17, 183–191.
Tamo is working in the field of cognitive
neuroscience.
CARLA TRELOAR, PhD, is an Associate Professor
and Head of the NCHSR Hepatitis C
Programme. She is a social and health
psychologist with a long-standing interest in
bloodborne virus infections, injecting and other
illicit drug use.