Hepatitis B is stigmatized across many Asian communities

StephenW

Hepatitis B Screeners Target The Asian-American Community                                                   

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• By Adam Ragusea  (@aragusea)  and Jeremy Bernfeld
• Nov 16, 2010, 3:30 PM  UPDATED 5:39 PM
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                                                                                Asian-Americans account for less than 10 percent of Boston’s population but are diagnosed with more than half of the city’s Hepatitis B cases.
In many carriers, the chronic viral infection of the liver ultimately causes liver cancer, and the mortality rate from that cancer among Asians is nearly triple the citywide average.
An estimated one in ten Asian-Americans is carrying the virus, but it’s hard to know for sure because the virus can lay dormant for years. And many never get screened or vaccinated due to social stigma or lack of awareness.
One Saturday each year, the Buddhist Tzu Chi Foundation, a global NGO, holds an enormous community health day in the Boston area. It used to hold it in Chinatown, but as Asian-Americans have spilled into suburbs such as Lexington and Lowell, so has the health fair.
On Saturday, the fair set up at Quincy North High School with more than 150 health care professionals and exhibitors.
In one corner, a group of bright-eyed Harvard kids waited patiently for patients.
They’re called Team HBV and they’re a student outreach group that works to promote Hepatitis B screening and awareness. There are chapters across the country in cities with big Asian populations.
Janie Zhang, a biology student at Harvard, helped staff Team HBV’s booth.
When Zhang was little, both of her parents worked in public health in China, where Hepatitis B is endemic. Despite it being the family business, Zhang was, like most people, stunningly ignorant of how Hepatitis B works.
“Most Asians think that Hepatitis B can be spread through touching or food,” Zhang said. “When I was younger I had a neighbor who had Hepatitis B, and then my mom asked him to babysit me a few times. I was terrified to enter his house and eat his food, because I though Hepatitis B could be spread through food, too. So it’s a really common misperception.”
Despite its prevalence, Hepatitis B is stigmatized across many Asian communities. It used to be more or less untreatable, so carriers just opted to hide it. Perhaps that’s why Zhang and Team HBV didn’t get a whole lot of business at the health fair where they offered free screenings.
Finally, however, a middle-aged Mandarin-speaking woman we’ll call “Julie” approached the booth.
At the booth, Team HBV asked attendees for some medical and demographic information, but mostly it was a sneaky way of forcing some education on “Julie” and other attendees.
The first question asked how many Asian-Americans have Hepatitis B; the next asked how Hepatitis B is transmitted.
“She didn’t realize that Hepatitis B couldn’t be transmitted though food or touching,” Zhang said, “and that’s also another one of our key messages that we want to get out there to reduce discrimination and prejudice against people with Hepatitis B.”
In fact, Hepatitis B is blood-borne, most often passed from mother to child, but also through sex or needles.
“Julie” will get her results in the mail in a couple weeks. There is a Hepatitis B vaccine and if “Julie” comes up negative, there are a number of clinics around Boston where she can get a free vaccination. It’s a series of three shots patients have to take over six months, so that’s why it’s hard to get people vaccinated.
If she’s positive, she’ll need to see a doctor, have her liver function monitored regularly, and probably go on a permanent anti-viral regimen. It’s like HIV. There used to be nothing that could be done, and that drove the disease underground, but now the right drugs can keep it under control.
Twenty-five percent of the time hepatitis B leads to liver cancer or cirrhosis, and by the time liver cancer is symptomatic, it’s often too late. The only cure is a liver transplant.

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