Hepatitis C, blood and models of the body: New directions for public health

Abstract

Hepatitis C is a major public health challenge, and efforts to reduce the transmission of hepatitis C among people who inject drugs (IDU) have had limited success. From within a harm minimization perspective, this study sought to examine the models of blood and the body used in health promotion materials designed to encourage safer injecting practice, and aspects of the body emphasized in interviews with 32 IDU. Of particular interest were the unstated, implicit models of blood and the body evoked in metaphors, language and symbols used to describe blood and the body. Health promotion messages relied heavily on fortress models of the body, that is, rigid definitions of bodily boundaries that define outside or foreign substances as hostile. Descriptions of blood by IDU were more complex including strong views of blood as both vital and fatal to life. Blood was seen as generally life saving and, at the societal level in terms of blood banking, in need of protection. An alternative model of education was, therefore, developed to highlight the multi-level responsibilities in caring for blood, to position blood as a shared social resource and to acknowledge the positive value in sharing resources. This model has the potential to reduce harm within the context of hepatitis C prevention without contributing to the further stigmatization of IDU.

Keywords:

• Hepatitis C
• health promotion
• representations of the body