Stigma Case Study

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1.5 Stigma associated with Tuberculosis Stigma involves “exclusion, rejection, blame, or devaluation resulting from experience or reasonable anticipation of an adverse social judgment” because of a particular condition (Weiss & Ramakrishna, 2006, p. 536).TB stigma involves such things as stereotyping, exclusion, rejection, devaluation, status loss or blame of an individual or family as a result of having TB. Historically, TB has been stigmatized because it is contagious and also due to incorrect knowledge of its cause, transmission, or treatment, or its association with marginalized group (Baral, Karki, & Newell, 2007 ; Kipp et al., 2011; Sengupta et al., 2006). Social stigma has been documented as an important barrier for successful management…show more content…
Social stigma is not only a hindrance to seeking TB treatment early (Ahsan et al., 2004; C. Auer, J. Sarol, Jr., M. Tanner, & M. Weiss, 2000; Li et al., 2013; Skordis-Worrall et al., 2010) but also treatment adherence. The consequences of stigma can be seen affecting care-seeking behaviors, as people have been known to hide their TB status to family or friends, out of fear of being ostracized. Stigma associated with TB is therefore, a major impediment to early diagnosis and treatment favouring transmission. Research has demonstrated that in some cases, personal rejection occurs as a result of strong stigma surrounding TB. Some of the causes of self-discrimination identified include fear of transmitting TB, avoiding gossip and potential discrimination (Baral et al., 2007 ).Three decades into the HIV and AIDS pandemic, stigma remains a significant challenge for HIV and AIDS and TB control programs across the prevention-to-care continuum. Tuberculosis has been and still is often considered a ‘‘dirty disease’’, ‘‘a death penalty’’ or as affecting ‘‘guilty people’’(Nguyen Hoang Long, Johansson, Diwan, & Winkvist, 2001). Many people still believe only those with HIV and AIDS have TB. Others believe TB to be a curse. This discourages TB cases from seeking treatment posing great risks to others. In a study done In Thailand people defined persons with weight loss, fever and cough as having AIDS and…show more content…
In a study done in Russia, Woith and Larson found that among patients with active pulmonary TB, TB stigma was a predictor of treatment adherence (Woith & Larson, 2008).Although internalized stigma is expected to lead to non-adherence, participants who experienced stigma in this study were more adherent to the TB treatment. The explanation given to this controversial findings is that TB stigma is not permanent and the motivation to come out of the stigmatizing condition may motivate patients to adhere to the treatment. According to Ngamvithayapong, TB stigma ends when one stops to cough and this may make patients to adhere to medication to get healed before the public realizes that they have the disease (Jintana Ngamvithayapong et al., 2000) . This is contrary to another study done in Pakistan that showed TB stigma was associated with noncompliance to treatment (Meulemans et al., 2002).The study showed that economic, demographical, geographical, and psychological and socio-cultural factors impacts on the patient’s ability to comply with the treatment regime. Both studies were surveys involving tuberculosis patients on treatment. In both studies attempts were made to measure stigma using social impact scales and its association with treatment adherence gave conflicting ideas. Judging from these divergent findings indeed the effect of stigma on promptness to seek TB treatment and adherence to the treatment has not

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