Journal Article

Perceptions about hepatitis C and barriers and enablers to screening and treatment among Egyptian immigrants to Canada: a theory-informed qualitative study

Thomas, Isabella M., Greenaway, Christina, Mortazhejri, Sameh, Pakhale, Smita, Alghamyan, Amjad, Cooper, Curtis, Mansour, Sarah, Presseau, Justin, Patey, Andrea M., Grimshaw, Jeremy M.

2025

Overview

Background Despite availability of effective screening and treatment for Hepatitis C (HCV), the uptake remains suboptimal. Immigrants from HCV endemic countries comprise 35% of cases in Canada. There is an average 10-year diagnosis delay, causing poor health outcomes and high healthcare system costs. Therefore, we aimed to understand immigrants’ perceptions and beliefs about HCV, as well as the barriers and enablers to HCV care among immigrants, with a focus on individuals from Egypt, given the country’s high endemic rates of HCV infection and the large Egyptian community in Canada. Methods We established a Community Advisory Group to provide advice at all stages. We used a qualitative-descriptive design guided by the Common-Sense Self-Regulation Model and Theoretical Domains Framework to perform semi-structured interviews with adult immigrants from Egypt (with or without HCV) in Ottawa, Canada. Sampling continued until thematic saturation was achieved. The interviews were double-coded and key findings were identified. Results We conducted interviews with 18 individuals (eight females, ten males), including 12 who had undergone HCV screening. Among them, seven had tested positive, and all had received treatment. While all participants were aware of HCV, misconceptions and a lack of knowledge regarding its symptoms, modes of transmission, and treatment options were prevalent. Many stated that they would not seek screening in the absence of significant symptoms. Perceived stigma associated with HCV and experiences of ethnocultural discrimination discouraged some individuals from seeking care. Additionally, challenges such as limited access to family doctors and long wait times were frequently cited as barriers. However, those who had received HCV treatment reported positive experiences and remained engaged in follow-up care. Conclusion There is an urgent need to improve access to care for immigrants from endemic countries to eliminate HCV in Canada. We took a systematic, theory-informed approach to understand lived experiences and views among Egyptian immigrants in Canada. We identified key factors contributing to the low uptake of HCV screening and treatment. These findings will inform a theory-based intervention to optimize HCV care in immigrant communities.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Analysis / Asymptomatic / Barriers / Behavior / Canada - epidemiology / Care and treatment / Citizenship / Community / Diagnosis / Disease transmission / Egypt - ethnology / Emigrants and Immigrants - psychology / Emigrants and Immigrants - statistics & numerical data / Emotions / Equality and Human Rights / Family medicine / Female / Health aspects / Health Knowledge, Attitudes, Practice / Health Policy / Health Promotion and Disease Prevention / Health Services Accessibility / Health Services Research / Hepatitis / Hepatitis C / Hepatitis C - diagnosis / Hepatitis C - ethnology / Hepatitis C - psychology / Hepatitis C - therapy / Humans / Illnesses / Immigrants / Implementation science / Infections / Interviews / Liver cancer / Male / Mass Screening / Medical care, Cost of / Medicine / Medicine & Public Health / Methods / Middle Aged / Patient Acceptance of Health Care / Perception / Population / Prevention / Public Health / Qualitative Research / Risk factors / Social aspects / Social Justice / Social Policy / Theoretical domains framework