A scoping review of health-related stigma outcomes for high-burden diseases in low- and middle-income countries

• Published in: BMC medicine Vol. 17; no. 1; p. 17
• Main Authors: Kane, Jeremy C, Elafros, Melissa A, Murray, Sarah M, Mitchell, Ellen M H, Augustinavicius, Jura L, Causevic, Sara, Baral, Stefan D
• Format: Journal Article
• Language: English
• Published: England BioMed Central 15.02.2019; BMC
• Subjects: Acquired immune deficiency syndrome; AIDS; Correlation analysis; Depression; Developing Countries; Disease control; Disorders; Drug use; Epilepsy; Health care; Health problems; HIV; HIV Infections; Human immunodeficiency virus; Humans; Income; Longitudinal studies; Low income groups; Low- and middle-income countries; Male; Medicin och hälsovetenskap; Mental depression; Mental Disorders; Mental health; Minority & ethnic groups; Moderators; Social Stigma; Stigma; Substance use; Substance-Related Disorders; Transgender persons; Tuberculosis; Womens health; Asia; India; Substance use; Tuberculosis; HIV; Low- and middle-income countries; Stigma; Epilepsy; Scoping review; Depression
• ISSN: 1741-7015; 1741-7015
• DOI: 10.1186/s12916-019-1250-8

Stigma is associated with health conditions that drive disease burden in low- and middle-income countries (LMICs), including HIV, tuberculosis, mental health problems, epilepsy, and substance use disorders. However, the literature discussing the relationship between stigma and health outcomes is largely fragmented within disease-specific siloes, thus limiting the identification of common moderators or mechanisms through which stigma potentiates adverse health outcomes as well as the development of broadly relevant stigma mitigation interventions. We conducted a scoping review to provide a critical overview of the breadth of research on stigma for each of the five aforementioned conditions in LMICs, including their methodological strengths and limitations. Across the range of diseases and disorders studied, stigma is associated with poor health outcomes, including help- and treatment-seeking behaviors. Common methodological limitations include a lack of prospective studies, non-representative samples resulting in limited generalizability, and a dearth of data on mediators and moderators of the relationship between stigma and health outcomes. Implementing effective stigma mitigation interventions at scale necessitates transdisciplinary longitudinal studies that examine how stigma potentiates the risk for adverse outcomes for high-burden health conditions in community-based samples in LMICs.