Enabling Person‐Centred Chronic Hepatitis B Care Among Migrant Men Who Have Sex With Men and Female Sex Workers
Horas T. H. Wong, Jack Wallace, Ian Anderson, Loren Brener, Jacqueline A. Richmond, Simin Yu, Anik Ray, Sarah Smith, Rick VarmaABSTRACT
Aim(s)
To explore experiences of chronic hepatitis B (CHB) care among migrant MSM and female sex workers attending a specialist sexual health clinic and identify perceived enablers of person‐centred care.
Design
Qualitative interview study.
Methods
Semi‐structured interviews with 14 overseas‐born men who have sex with men (MSM, n = 7) and cisgender and transgender female sex workers ( n = 7) attending a publicly funded sexual health clinic in Sydney, Australia. Data were analysed using thematic analysis, with interpretation informed by the Person‐Centred Practice Framework.
Results
Sexual health services were experienced as safe spaces where CHB was often identified during routine screening, enabling participants to initiate or re‐engage with care. Care engagement was shaped by macro‐context factors including visa status, Medicare access, language needs, culturally embedded understandings of CHB and referral pathways. Trusting relationships with sexual health practitioners supported discussion of sex, migration and CHB, although some interactions were experienced as directive and overly risk‐focused, undermining relational safety. Participants described CHB as having low salience in everyday life but becoming more prominent during intimate moments such as disclosure, partner reassurance and sex work decisions. For some participants, PrEP or HIV therapy offered dual HIV–CHB benefits, making treatment feel more worthwhile and easier to take up. Participants navigated system barriers through peer networks, information‐seeking, and services aligned with their needs.
Conclusion
Person‐centred CHB care for migrant MSM and female sex workers requires more than clinical monitoring. Care should be responsive to the intersecting effects of migration, sexuality, sex work, intimacy and access to health services, while creating culturally and relationally safe environments that support trust, disclosure and sustained engagement.
Implications
This study calls for embedding CHB care within routine sexual health and HIV care, strengthening language support, improving referral coordination, and supporting clinicians to use reflexive, non‐directive communication to avoid moralising or ‘risk‐only’ framings.
Patient or Public Contribution
None.