Department of Medicine, Melbourne Medical School, The University of Melbourne, Parkville, VIC 3010, Australia.
Burnet Institute, Melbourne, VIC 3004, Australia.
Int J Environ Res Public Health. 2023 Mar 10;20(6):4879. doi: 10.3390/ijerph20064879.
Hepatitis B is a chronic condition, primarily associated with hepatitis B viral infection in early life. The failure of prevention and appropriate management can lead to subsequent liver cirrhosis and cancer. Hepatitis B most commonly affects people born in Asia and Sub-Saharan Africa and their global diasporas. The physical, psychological, and social impacts of hepatitis B are strongly influenced by sex and gender. Inequities in access to timely, sensitive diagnosis and effective management arise from interactions between structural inequalities related to race, ethnicity, Indigenous/settler status, class, and geography. The biomedical response to hepatitis B has led to advances in prevention, diagnosis, and treatment, but many affected communities have explanatory health belief models that differ from that of biomedicine. We argue that an intersectional approach, led by affected people and communities, can integrate biomedicine with the lived experience and social context that give purpose to and shape all personal, communal, clinical, and public health responses to hepatitis B. This approach has the potential to enable a consciously equitable, effective response to the biopsychosocial complexities of hepatitis B, improve the health and wellbeing of people living with hepatitis B, and reduce hepatitis B-associated mortality.
乙型肝炎是一种慢性疾病，主要与生命早期的乙型肝炎病毒感染有关。预防和适当管理的失败可能导致随后的肝硬化和癌症。乙型肝炎最常见于亚洲和撒哈拉以南非洲以及他们的全球侨民出生的人群中。乙型肝炎的身体、心理和社会影响受到性别强烈影响。由于与种族、民族、原住民/定居者地位、阶级和地理位置有关的结构性不平等的相互作用，在及时、敏感的诊断和有效管理方面存在获得机会的不平等。乙型肝炎的生物医学反应导致了预防、诊断和治疗方面的进展，但许多受影响的社区都有不同于生物医学的解释性健康信念模型。我们认为，由受影响的个人和社区领导的交叉方法可以将生物医学与赋予意义和塑造所有个人、社区、临床和公共卫生对乙型肝炎的反应的生活经历和社会背景相结合。这种方法有可能使乙型肝炎的生物心理社会复杂性得到有意识的公平、有效的应对，改善乙型肝炎患者的健康和福祉，并降低乙型肝炎相关死亡率。
