Document Type


Degree Name

Master of Arts (MA)




Faculty of Science

First Advisor

Dr. Ketan Shankardass

Advisor Role



Hepatitis C (HCV) remains a global issue as it affects 2-3% of the world’s population. Despite Canada’s universal access to healthcare, barriers to accessing testing and treatment for HCV has contributed to approximately 250,000 Canadians living with chronic HCV. People who inject drugs (PWID) account for about 60% of all HCV cases in Canada, making them the primary target for public health interventions, namely prevention and harm reduction. Harm reduction efforts have proven effective to reduce the incidence of infectious diseases and to prevent overdoses, but there remains a large proportion of individuals living with the virus who are unaware of their status and who require treatment. Current HCV discourse lacks a local understanding of barriers and facilitators in the Canadian context. This study explored the experience of accessing HCV testing and treatment among PWID, identifying barriers and facilitators to HCV care throughout the individual’s journey from diagnosis to cure within four domains of access: acceptability, availability, affordability, and geographic accessibility. The role of the client-provider relationship and the impact of harm reduction was also considered as it hinders or facilitates the accessibility of HCV testing and treatment. Qualitative interviews were conducted with clients (self-identified current or former intravenous substance user) and health providers in the Waterloo and Peel Regions of Ontario. Stigma and misinformation of HCV and substance use were regarded as systemic forces that perpetuate oppression, reflected throughout all access domains on a community and individual level. Facilitators and solutions identified in this study indicate a need to apply community health models and resources, more widely adopt harm reduction and patient- centred approaches to clinical care, and further consider or utilize intersectoral action to ensure equitable access to health services.

Convocation Year


Convocation Season