In the intricate fabric of global health challenges, hepatitis C remains a significant yet often overlooked concern, especially within vulnerable immigrant populations. Recently, an illuminating study conducted by Mortazhejri, Thomas, Patey, and colleagues has shed critical light on the perceptions of hepatitis C among Egyptian immigrants in Canada. Their work, published in the International Journal for Equity in Health in 2025, explores the complex interplay of social, cultural, and systemic factors that shape the willingness and ability of this community to engage in hepatitis C screening and treatment programs. This groundbreaking qualitative inquiry goes beyond quantifying disease burden to unravel the subjective experiences that drive health behaviors and outcomes.
Hepatitis C virus (HCV) is a bloodborne pathogen that can lead to chronic liver disease, cirrhosis, and hepatocellular carcinoma if left untreated. Despite significant advances in antiviral therapies that can effectively cure the infection in over 90% of cases, global eradication remains elusive. Barriers such as stigma, misinformation, and limited access to healthcare continue to hinder efforts, particularly in marginalized groups such as immigrant communities. Egyptian immigrants to Canada represent a unique case due to the high endemicity of HCV in Egypt historically and the consequent heightened risk carried by this population, coupled with the challenges of navigating a new health system.
The study employs a robust theoretical framework drawing on health behavior theories, including the Health Belief Model and Social Cognitive Theory, to structure qualitative inquiries and interpret findings. Through in-depth interviews and focus groups, researchers captured nuanced insights from Egyptian immigrants themselves, alongside healthcare providers familiar with their experiences. This approach allows a granular understanding of not only what barriers exist but why they resonate so profoundly within this community’s cultural psyche.
One of the predominant revelations of the research highlights the pervasive stigma surrounding hepatitis C. Participants frequently associated HCV with moral judgment, fear, and social isolation, deterring many from openly seeking screening or treatment. These stigmatizing attitudes are compounded by misconceptions about transmission routes, with some individuals fearing casual contact. This points to an urgent need for culturally sensitive education campaigns that dismantle myths and normalize discussions around the disease, fostering an environment where seeking help is perceived as an empowered act rather than one of shame.
Access to healthcare emerged as another critical barrier, intertwined with logistical, linguistic, and systemic challenges. Many immigrants expressed difficulties in navigating Canada’s healthcare infrastructure, particularly regarding specialist referrals and follow-up care necessary for hepatitis C management. Language barriers and a lack of culturally competent services further alienated some community members, underscoring the importance of integrating interpreters and culturally tailored care strategies into health programs.
Enablers identified by the study offer a blueprint for effective intervention. Trust in healthcare providers was a recurring theme, with participants more likely to engage in screening and treatment when services were delivered by professionals who demonstrated cultural humility and sensitivity. Community-based outreach, leveraging trusted local leaders and peer educators, was also noted as a promising avenue to bridge gaps between healthcare institutions and Egyptian immigrants.
The implications of this research extend beyond the Egyptian Canadian community. It provides a compelling case study on how social determinants of health, intersecting with immigration status and cultural factors, shape disease prevention and treatment landscapes. In an era where precision public health is gaining traction, understanding these socio-cultural determinants enables the tailoring of interventions that resonate deeply with target populations, enhancing uptake and ultimately health outcomes.
Importantly, the study’s design incorporates a theory-informed qualitative methodology that bestows it with analytical rigor and richness. Unlike quantitative studies limited to prevalence statistics or care cascade metrics, this qualitative approach excavates the lived realities of participants, translating complex human emotions and social dynamics into actionable health insights. This methodology sets a standard for future research seeking to address health inequities with both empathy and scientific precision.
The timing of this study is particularly poignant, as global health policymakers strive to meet the World Health Organization’s goals for viral hepatitis elimination by 2030. Immigrant populations are often disproportionately impacted by diseases like hepatitis C, and national elimination frameworks cannot succeed without strategies tailored to these groups. By elucidating specific barriers and cultural facilitators within a distinct immigrant community, the research offers valuable lessons that can inform public health programming on a broader scale.
Technological advances in hepatitis C treatment—primarily direct-acting antivirals—have transformed the clinical landscape, offering shorter, more tolerable, and highly effective regimens. However, the biomedical revolution alone is insufficient if social and cultural obstacles remain unaddressed. This study’s findings advocate for integrated care models where clinical efficacy is matched by community engagement and culturally competent service delivery. Only such holistic approaches can ensure equitable access to curative therapies.
Furthermore, the role of mental health and fear emerged as significant determinants in the decision-making processes of participants regarding hepatitis C screening. Anxiety about receiving a positive diagnosis, coupled with concerns about confidentiality and potential negative repercussions within tight-knit immigrant networks, weighed heavily. This psychological dimension underscores the necessity of embedding psychosocial support within screening initiatives, alleviating fears and building resilience.
The work also draws attention to the interaction between prior experiences in immigrants’ home countries and their healthcare behaviors post-migration. Many Egyptian immigrants carry with them not only the epidemiological risk of hepatitis C but also pre-existing attitudes shaped by the health communication and service delivery landscapes of Egypt. This transnational perspective is critical; health interventions in host countries must recognize and incorporate elements of migrants’ health histories to be fully effective.
Cumulatively, the insights from this qualitative study enrich the expanding discourse on health equity and immigrant health. They illuminate pathways for clinicians, public health practitioners, and policymakers to reconceptualize hepatitis C screening and treatment beyond clinical protocols, advocating for culturally attuned, community-driven strategies. As healthcare systems become more diverse and globally interconnected, these findings emphasize that scientific progress depends equally on cultural intelligence and social innovation.
The meticulous layered analysis presented by Mortazhejri and colleagues serves as a clarion call to embed equity at the core of infectious disease control efforts. By centering immigrant voices and experiences, their work challenges researchers and practitioners alike to transcend traditional epidemiological approaches and to cultivate empathetic, contextually relevant interventions. This is not merely a template for hepatitis C care but a model for addressing other health disparities that pervade immigrant and marginalized populations worldwide.
In conclusion, the exploration of hepatitis C perceptions among Egyptian immigrants in Canada encapsulates critical themes in contemporary public health: the intersection of culture, access, stigma, and medical innovation. The study’s deep qualitative insights pave the way for interventions that are not only scientifically sound but socially resonant, promising a future where hepatitis C elimination efforts become truly inclusive. As the global health community advances towards ambitious elimination goals, such nuanced understanding will be indispensable in ensuring no populations are left behind.
Subject of Research: Perceptions of hepatitis C, barriers and enablers to hepatitis C screening and treatment among Egyptian immigrants to Canada
Article Title: Perceptions about hepatitis C and barriers and enablers to screening and treatment among Egyptian immigrants to Canada: a theory-informed qualitative study
Article References:
Mortazhejri, S., Thomas, I.M., Patey, A.M. et al. Perceptions about hepatitis C and barriers and enablers to screening and treatment among Egyptian immigrants to Canada: a theory-informed qualitative study. Int J Equity Health 24, 203 (2025). https://doi.org/10.1186/s12939-025-02582-4
Image Credits: AI Generated
