Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-23T18:49:46.077Z Has data issue: false hasContentIssue false
  • English
  • Français

Addressing Disease-Related Stigma During Infectious Disease Outbreaks

Published online by Cambridge University Press:  03 June 2019

Leah S. Fischer ,
Gordon Mansergh ,
Jonathan Lynch  and
Scott Santibanez
Leah S. Fischer*
Affiliation:
Centers for Disease Control and Prevention, Division of Preparedness and Emerging Infections, Atlanta, GA
Gordon Mansergh
Affiliation:
Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, GA
Jonathan Lynch
Affiliation:
Centers for Disease Control and Prevention, Division of Emergency Operations, Atlanta, GA
Scott Santibanez
Affiliation:
Centers for Disease Control and Prevention, Division of Preparedness and Emerging Infections, Atlanta, GA
*
Correspondence and reprint requests to Dr Leah Fischer, Centers for Disease Control and Prevention, Division of Preparedness and Emerging Infections, 1600 Clifton Road, MS-C18, Atlanta, GA 30333 (e-mail: [email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

Outbreaks of emerging infectious disease are a constant threat. In the last 10 years, there have been outbreaks of 2009 influenza A (H1N1), Ebola virus disease, and Zika virus. Stigma associated with infectious disease can be a barrier to adopting healthy behaviors, leading to more severe health problems, ongoing disease transmission, and difficulty controlling infectious disease outbreaks. Much has been learned about infectious disease and stigma in the context of nearly 4 decades of the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome pandemic. In this paper, we define stigma, discuss its relevance to infectious disease outbreaks, including how individuals and communities can be affected. Adapting lessons learned from the rich literature on HIV-related stigma, we propose a strategy for reducing stigma during infectious disease outbreaks such as Ebola virus disease and Zika virus. The implementation of brief, practical strategies such as the ones proposed here might help reduce stigma and facilitate more effective control of emerging infectious diseases.

Keywords

infectious diseasepublic health responsestigma
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 13 , Issue 5-6 , December 2019 , pp. 989 - 994
Copyright
Copyright © 2019 Society for Disaster Medicine and Public Health, Inc. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Kraut, AM. Quarantine! East European Jewish immigrants and the New York City epidemics of 1892. Bull Hist Med. 1998;72(4):785–786. doi: 10.1353/bhm.1998.0196.CrossRefGoogle Scholar
Perry, P, Donini-Lenhoff, F. Stigmatization complicates infectious disease management. AMA J Ethics. 2010;12(3):225–230.Google ScholarPubMed
American Experience. The forgotten plague: TB in America: 1895–1954. Episode premiered in 2015. https://www.pbs.org/wgbh/americanexperience/features/plague-gallery/. Accessed July 16, 2018.Google Scholar
Chang, SH, Cataldo, JK. A systematic review of global cultural variations in knowledge, attitudes and health responses to tuberculosis stigma. Int J Tuberc Lung Dis. 2014;18(2):168–173.CrossRefGoogle ScholarPubMed
Cava, MA, Fay, KE, Beanlands, HJ, et al. The experience of quarantine for individuals affected by SARS in Toronto. Public Health Nurs. 2005;22(5):398–406.CrossRefGoogle ScholarPubMed
Lin, EC, Peng, YC, Tsai, JC. Lessons learned from the anti-SARS quarantine experience in a hospital-based fever screening station in Taiwan. Am J Infect Control. 2010;38(4):302–307.CrossRefGoogle Scholar
Maleche, A, Citro, B, Tisile, P, et al. Measuring TB-related stigma. Int J Tuberc Lung Dis. 2017;21(11):4–5.CrossRefGoogle ScholarPubMed
Oaten, M, Stevenson, RJ, Case, TI. Disease avoidance as a functional basis for stigmatization. Philos Trans R Soc Lond B Biol Sci. 2011;366(1583):3433–3452.CrossRefGoogle ScholarPubMed
Hatzenbuehler, ML, Phelan, JC, Link, BG. Stigma as a fundamental cause of population health inequalities. AJPH. 2013;103(5):813–821.CrossRefGoogle ScholarPubMed
Greco, RS. Haiti and the stigma of AIDS. Lancet. 1983;322(8348):515–516.CrossRefGoogle Scholar
Earnshaw, V, Chaudoir, V. From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures. AIDS Behav. 2009;13(6):1160–1177. doi: 10.1007/s10461-009-9593-3.CrossRefGoogle ScholarPubMed
Deacon, H. Towards a sustainable theory of health-related stigma: lessons from the HIV/AIDS literature. J Community Appl Soc Psychol. 2006;16:418–425. doi: 10.1002/casp.900.CrossRefGoogle Scholar
Smith, R, Rossetto, K, Peterson, BL. A meta-analysis of disclosure of one’s HIV-positive status, stigma and social support. AIDS Care. 2008;20(10):1266–1275. doi: 10.1080/09540120801926977.CrossRefGoogle ScholarPubMed
Darrow, WW, Montanea, JE, Gladwin, H. AIDS-related stigma among black and Hispanic young adults. AIDS Behav. 2009;13(6):1178–1188.CrossRefGoogle ScholarPubMed
Sweeny, S, Vanable, P. The association of HIV-related stigma to HIV medication adherence: a systematic review and synthesis of the literature. AIDS Behav. 2016;20:29–50.CrossRefGoogle Scholar
Rueda, S, Mitra, S, Chen, S, et al. Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: a series of meta-analyses. BMJ Open. 2016;6:e011453. doi: 10.1136/bmjopen-2016-011453.CrossRefGoogle Scholar
Lowther, K, Selman, L, Harding, H, et al. Experience of persistent psychological symptoms and perceived stigma among people with HIV on antiretroviral therapy (ART): a systematic review. Int J Nurs Stud. 2014;51:1171–1189.CrossRefGoogle ScholarPubMed
Comfort, J, McCausland, K. Health priorities and perceived health determinants among Western Australians attending the 2011 LGBTI Perth Pride Fairday Festival. Health Promot J Austr. 2013;24(1): 20–25.CrossRefGoogle ScholarPubMed
Courtenay-Quirk, C, Wolitski, RJ, Parsons, JT, et al. Is HIV/AIDS stigma dividing the gay community? Perceptions of HIV-positive men who have sex with men. AIDS Educ Prev. 2006;18(1):56–67.CrossRefGoogle ScholarPubMed
Preston, DB, D’Augelli, AR, Kassab, CD, et al. The influence of stigma on the sexual risk behavior of rural men who have sex with men. AIDS Educ Prev. 2004;16(4):291–303.CrossRefGoogle ScholarPubMed
Rowe, C, Santos, GM, McFarland, W, et al. Prevalence and correlates of substance use among trans female youth ages 16-24 years in the San Francisco Bay Area. Drug Alcohol Depend. 2015;147:160–166.CrossRefGoogle ScholarPubMed
Mansergh, G, Spikes, P, Flores, SA, et al. Internalised homophobia is differentially associated with sexual risk behaviour by race/ethnicity and HIV serostatus among substance-using men who have sex with men in the United States. Sex Transm Infect. 2015;91(5):324–328.CrossRefGoogle Scholar
Rood, EJJ, Mergenthaler, C, Bakke, MI, et al. Using 15 DHS surveys to study epidemiological correlates of TB courtesy stigma and health-seeking behaviour. Int J Tuberc Lung Dis. 2017;21(Suppl1):S60–S68.CrossRefGoogle ScholarPubMed
Sommerland, N, Wouters, E, Masquillier, C, et al. Stigma as a barrier to the use of occupational health units for tuberculosis services in South Africa. Int J Tuberc Lung Dis. 2017;21(Suppl 1):S75–S80.CrossRefGoogle ScholarPubMed
Chikovore, J, Hart, G, Kumwenda, M, et al. TB and HIV stigma compounded by threatened masculinity: implications for tuberculosis health-care seeking in Malawi. Int J Tuberc Lung Dis. 2017;21(Suppl 1):S26–S33.CrossRefGoogle ScholarPubMed
Skinner, D, Claassens, MM. It’s complicated: why do tuberculosis patients not initiate treatment? A qualitative study from South Africa. BMC Infect Dis. 2016;16:712.CrossRefGoogle Scholar
Faccini, M, Cantoni, S, Ciconali, G, et al. Tuberculosis-related stigma leading to an incomplete contact investigation in a low incidence country. Epidemiol Infect. 2015;143:2841–2848.CrossRefGoogle Scholar
Johns Hopkins Center for Health Security. Health sector resilience checklist for high-consequence infectious diseases–informed by the domestic US Ebola response. Published 2017. http://www.centerforhealthsecurity.org/our-work/pubs_archive/pubs-pdfs/2017/HCID_Final_Report_05.23.2017.pdf. Accessed July 7, 2017.Google Scholar
Hunt, D, Solís, D. Dallas’ Vickery Meadow residents enduring backlash over Ebola. The Dallas Morning News. October 2014. http://www.dallasnews.com/news/metro/20141006-dallas-vickery-meadow-residents-endure-shunning-over-ebola.ece. Accessed January 12, 2018.Google Scholar
Sanders, S. Dallas Ebola patient’s neighborhood deals with new stigma. All Things Considered. October 7, 2014. http://www.npr.org/2014/10/07/354371663/dallas-ebola-patients-neighborhood-deals-with-new-stigma. Accessed January 12, 2018.Google Scholar
Malavé, S, Ramakrishna, J, Heylen, E, et al. Differences in testing, stigma, and perceived consequences of stigmatization among heterosexual men and women living with HIV in Bengaluru, India. AIDS Care. 2014;26(3):396–403.CrossRefGoogle ScholarPubMed
Santibañez, S, Polgreen, PM, Beekmann, SE, et al. Infectious disease physicians’ perceptions about Ebola preparedness early in the US response: a qualitative analysis and lessons for the future. Health Secur. 2016;14(5):345–350.CrossRefGoogle ScholarPubMed
Geibel, S, Hossain, SM, Pulerwitz, J, et al. Stigma reduction training improves healthcare provider attitudes toward, and experiences of, young marginalized people in Bangladesh. J Adolesc Health. 2017;60(2S2):S35–S44.CrossRefGoogle ScholarPubMed
Crawford, ND, Amesty, S, Rivera, AV, et al. Community impact of pharmacy-randomized intervention to improve access to syringes and services for injection drug users. Health Educ Behav. 2014;41(4):397–405.CrossRefGoogle ScholarPubMed
Batey, DS, Whitfield, S, Mulla, M, et al. Adaptation and implementation of an intervention to reduce HIV-related stigma among healthcare workers in the United States: piloting of the FRESH workshop. AIDS Patient Care STDS. 2016;30(11):519–527.CrossRefGoogle ScholarPubMed
Stangl, AL, Lloyd, JK, Brady, LM, et al. A systematic review of interventions to reduce HIV-related stigma and discrimination from 2002–2013: how far have we come? J Int AIDS Soc. 2013;16(Suppl 2):18734.CrossRefGoogle Scholar
Brown, L, Macintyre, K, Trujillo, L. Interventions to reduce HIV/AIDS stigma: what have we learned? AIDS Educ Prev. 2003;15:49–69.CrossRefGoogle ScholarPubMed
Prinsloo, CD, Greeff, M, Kruger, A, et al. Psychosocial well-being of people living with HIV and the community before and after a HIV stigma-reduction community “hub” network intervention. Afr J AIDS Res. 2016;15(3):261–271.CrossRefGoogle ScholarPubMed
Lorway, R, Thompson, LH, Lazarus, L, et al. Going beyond the clinic: confronting stigma and discrimination among men who have sex with men in Mysore through community-based participatory research. Crit Public Health. 2014;24(1):73–87.CrossRefGoogle Scholar
Mburu, G, Ram, M, Siu, G, et al. Intersectionality of HIV stigma and masculinity in eastern Uganda: implications for involving men in HIV programmes. BMC Public Health. 2014;14:1061.CrossRefGoogle ScholarPubMed
Herrick, AL, Stall, R, Chmiel, JS, et al. It gets better: resolution of internalized homophobia over time and associations with positive health outcomes among MSM. AIDS Behav. 2013;17(4):1423–1430.CrossRefGoogle ScholarPubMed
Markham, C, Baumler, E, Richesson, R, et al. Impact of HIV-positive speakers in a multicomponent, school-based HIV/STD prevention program for inner-city adolescents. AIDS Educ Prev. 2000;12:442–454.Google Scholar