Non-Uptake of Treatment For Hepatitis C in The Antiviral Era: A Qualitative Analysis

Author: Renae Fomiatti Suzanne Fraser David Moore Adrian Farrugia Carla Treloar

Theme: Social Science & Policy Research Year: 2022

With new hepatitis C treatment regimes a vast improvement on interferon-based regimes, many
people have undergone treatment and been cured. Alongside this group, however, are those who
have not taken up treatment, even where it is free and readily available. With Australia’s aim of
eliminating the disease by 2030, this group are of concern to researchers, health professionals and
This presentation draws on 50 interviews conducted for a research project on treatment uptake.
Informed by Berlant’s (2007) work on ‘slow death’ and the ‘wearing out of populations’ under late
capitalist neo-liberalism, it focuses on three cases of non-uptake to explain the dynamics at work in
such apparently inexplicable and individually disadvantageous outcomes.
The analysis has three parts, each focusing on one case to illuminate broader issues. First, Cal
describes a lifetime in which hepatitis C, homelessness and prison have shaped his outlook and
opportunities. Second, Evan describes intergenerational drug consumption, family contact with the
prison system, and an equally long history with hepatitis C. Finally, Rose also describes a long history
of hepatitis C, complex efforts to improve life in difficult circumstances and contact with the prison
system. All three cases illuminate the processes shaping decisions about treatment, calling to mind
Berlant’s slow death as a condition of being ‘worn out by the activity of reproducing life’ under
conditions that both demand self-management, and work against it.
In concluding, the presentation points to the distinction between ‘epidemics’ and ‘endemics’ drawn
in Berlant’s piece, arguing that the politics of this distinction apply directly to hepatitis C. Offering a
novel interpretation of the conditions of hepatitis C’s reproduction, it steps out the need to address
the criminalising, pathologising capitalist carceral context of ‘attrition’ (Berlant) that wears out lives
even as it fetishises individual autonomy, responsibility and choice.
Disclosure of Interest Statement:
This research was funded by the Australian Research Council.

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