The new season (3) of the TV Series Wentworth has a story-line around the Hepatitis C Virus (HCV).
For those unaware, Wentworth is a critically acclaimed Australian TV Series on Foxtel’s Soho Channel about a women’s prison. It draws its inspiration from the groundbreaking 1980s Australian TV Series Prisoner. The emphasis is important: the deliberately confronting and challenging nature of this series (and its predecessor) means complex, and often otherwise ignored, issues are at the core of its storytelling.
The HCV story arc began in the first episode when Deputy Governor, Vera Bennett, was held hostage with the use of a blood-filled syringe. The situation was diffused, but we see Vera touch her hands to her neck afterwards and when she looks at them there’s blood, indicating the syringe spilled and/or punctured her neck. In a subsequent episode (4), a new, young prisoner is bailed up by a group of rough lesbian inmates with the clear intention of raping her. The leader of the pack says, “We’ve all got a touch of the Hep C, but the good news is you can only get it once”. Then, in episode 5, after suffering from a variety of symptoms, Vera visits her doctor who confirms she has HCV.
The incorporation of HCV into the show is commendable. While HIV has been the subject of an extensive campaign to improve society’s awareness and understanding, HCV has been largely overlooked. The result of this is that the community lacks accurate understanding of the illness’ transmission, impact and management, which in turn means stigma, discrimination and treatment issues remain. For example, it is a relatively common perception that all those with HCV must be (or must have been) drug addicts, but HCV can be transmitted through any blood to blood contact. This includes the sharing of razors and toothbrushes, blood transfusions that occurred prior to screening for HCV and dental equipment that is not properly steralised. By contrast, although transmission through sexual activity is possible, it is unlikely.
Not that it should make any difference how an illness is contracted. Civilised society, and Australia in particular, does not make treatment decisions based on responsibility or blame for the illness. We don’t deny alcoholics liver transplants nor obese people with diabetes insulin. We don’t question a person with HIV as to whether they have contracted it via sex or needle sharing. We don’t queue people at emergency departments based on whether they drove their car into a tree while looking at their mobile phone or were run off the road by someone else. But that’s digressing.
Returning to Wentworth, the manner in which HCV has been incorporated is cause for concern. When the young prisoner was about to be raped, the implication about HCV was that she was almost certain to contract it from the sexual activity; that that was the most concerning and scary part of the situation. This is particularly inaccurate in light of the fact that transmission during female-female sex would be even less likely than male-female sex due to the type of contact. Chances are the statement was to make the audience aware of the prisoner’s HCV in anticipation of the development of Vera’s situation. And certainly, that a character as straight-laced and conservative as Vera will be the vehicle to explore HCV goes a long way to addressing the misconceptions around the illness. But given the show’s credentials, it should strive for greater accuracy. There were many other ways they could have introduced the existence of HCV amongst the prison population that would have been more authentic.
A sincere and sensitive examination of HCV has never been more important. In the past 2 years, new anti-virals have come onto the market that offer cures for HCV with minimal side effects. The enormity of this cannot be overstated: previously the best that was on offer for viruses were drugs that helped reduce the viral load and increased the body’s own ability to combat the virus, and all have severe side effects. The new anti-virals are a win-win: substantially better for those with HCV and also saving the government millions of dollars in the cost of ongoing treatment for the physiological damage done by HCV to the liver and other parts of the body.
These new anti-virals are currently under consideration by the Australian Federal government for inclusion on the Pharmaceutical Benefits Scheme (PBS). Without inclusion on the PBS, which is government subsidisation of medication, the course of anti-virals will cost individuals in the vicinity of $100,000, prohibitive for many. Fortunately, on its second consideration, the Pharmaceutical Benefits Advisory Committee (PBAC), which advises the government about which medications should be on the PBS, recommended several of the new-antivirals for government subsidisation. However, this comes after an initial rejection by the PBAC and a great deal of work by those in the Hepatitis community campaigning for re-consideration. Health spending, specifically medication, has also been flagged by the government as an area for expenditure analysis and changes have been incorporated into the Federal Budget (handed down last night). So while greater public awareness and understanding of the issues facing those with HCV and the positives of the various treatments is beneficial, accuracy is equally, if not more, important.
Wentworth has an opportunity to contribute society’s education about HCV. And if the show is to do justice to sufferers of HCV and live up to its reputation of handling issues with integrity, it must ensure its HCV plot has both depth and authenticity.
For more information on HCV, there is a link to Hepatitis C Victoria in the information panel to the right.