A Qualitative Exploration of Family and Marital Challenges Faced by the Hepatitis-B Positive Patients and Their Partners in Central India.

Introduction: More than 40 million people in India are thought to be chronically infected with hepatitis B. Though envisaged in the year 2019, the national program for control of viral hepatitis is still in very nascent stage of implementation. The management of hepatitis B after diagnosis is heterogeneous all across the country and mostly out of reach of the vulnerable rural population far from cities with low socioeconomic status. There is a need to explore the impact of disease and the challenges faced by the patients and their partners. Methodology: The study is a qualitative research using in-depth interviews of the married couples with one of the partners diagnosed positive for HBsAg since at least 1 year. The interviews were conducted in vernacular language and transcripted by translation and back translation. The transcription was coded and thematically analyzed before interpretation of the results. The analysis was done using Atlas Ti software (version 7.1.8). Results: Themes identified in the interview were related to disease diagnosis, disease management, disease awareness, and impact on social or marital life. The awareness about the disease source or complication was suboptimal but awareness about sexual transmission of the infection was high. The disease diagnosis was mostly incidental, and in the majority of cases, they were diagnosed during pre-surgical tests. Most of the patients were not educated about the disease, lifelong treatment, prevention or screening among the family members, referral, or appropriate follow-ups. The availability of the medicines is a huge problem, and hence, all of our participants were non-adherent to medication. Conclusion: The findings of the study are valuable in view of huge burden of the disease and unavailability of universal treatment or information about the disease. The diseased person's experiences low discrimination or stigma as compared to other blood-borne infections, and hence, the epidemiology of disease provides an unique window of opportunity for awareness through authentic health information regarding the infection, prevention through vaccination, and screening. There is also a need for widespread provision of disease medications and standard guidelines for management.