A multi-domain qualitative study on the barriers to accessing preventive care among hepatitis B virus-infected individuals and high-risk populations

Objectives This study aimed to explore barriers precluding hepatitis B virus (HBV) preventive care among the rural population. Methods Guided by the National Institute on Minority Health and Health Disparities framework, this qualitative study applied an interpretative phenomenological approach. Participants (n = 34) were recruited from three healthcare settings in southern China from May 2024 to January 2025. Data from semi-structured interviews were analyzed using interpretative phenomenological analysis. Results Barriers spanned four domains with 11 subthemes. 1) Behavioral: the last-resort paradigm in healthcare utilization, reliance on folk remedies, and intergenerational silence in familial HBV prevention; 2) Physical environment: remote residence from healthcare facilities and compound vulnerabilities in living and working environments; 3) Sociocultural: the social death sentence of HBV discrimination, fatalistic resignation towards health, and the myth of the hardy survivor; and 4) Healthcare system: misperceptions, underestimated needs, and access barriers related to labor, mobility, and misaligned healthcare insurance policy. Conclusions These barriers perpetuate late HBV diagnosis, low vaccine uptake, and poor treatment adherence among the rural population. This highlights the need for mobile health services to overcome geographic barriers; culturally appropriate interventions to dismantle misinformation, HBV discrimination, and myths; and policies to reduce financial burden and improve insurance coverage, thereby making HBV preventive care accessible for this marginalized group.