Like many diseases, hepatitis C has always disproportionately affected Black folks, according to Julius Wilder, MD, PhD, a Black hep expert at the Duke School of Medicine.

Prior to the discovery of hep C in 1989, a disproportionate number of Black folks had that mysterious “non-A, non-B” hepatitis. This was not solely because of injection-drug use but because systemic racism, segregation, poverty and overpolicing landed more Black folks, especially men, in prison, where amateur tattooing and the sharing of razors—both drivers of hep C transmission—were common. 

After a test for hep C emerged in the ’90s, Black people were less likely to be tested—or even to know about testing—because they had less access to health care resources.

“It was a perfect storm of reasons why Black people were more affected by hep C,” says Wilder. 

Thankfully, even though racial disparities in access to health care persist, a lot has changed in the past decade. Today, hep C treatment is not only about as easy to take as a daily vitamin, sometimes causing only mild diarrhea or nausea in the first week or two, it’s also almost 100% effective in curing people regardless of race. 

The treatment is expensive, but it’s almost always covered by private insurance, Medicare and/or Medicaid—and even without those, says Wilder, patient assistance programs from pharmaceutical companies can make your share of the cost as low as zero. 

“Bottom line?” says Wilder. “You should be treated for hep C—and you can be.”

In recent years in the United States, new hep C infections have been driven by injection drug use linked to the opioid crisis—although this mode of transmission has been higher in whites and Native Americans than Blacks, says Wilder.

Nonetheless, anyone who shares needles or other injecting equipment is at risk of getting hep C, which is why if you or someone you know or love is injecting drugs, you should find a needle exchange center near you that can provide clean needles and other equipment free of charge as well as connect you to lifesaving resources—from overdose prevention medication to rehab for those who want it. 

To find a needle exchange or harm reduction center near you, visit nasen.org or harmreduction.org.