Characterizing hepatitis B stigma in Chinese immigrants

May 10, 2011

S. J. Cotler1, S. Cotler2, H. Xie3, B. J. Luc1, T. J. Layden1, S. S.

Wong1Article first published online: 4 MAY 2011

DOI: 10.1111/j.1365-2893.2011.01462.x

Issue

Journal of Viral Hepatitis

Early View (Online Version of Record published before inclusion in an issue)

Summary.â€‚ Health-related stigma is a cause of stress, alienation and

discrimination that can serve as a barrier to prevention and care for infectious

diseases such as HIV. Hepatitis B virus (HBV)-related stigma is common in Asian

immigrants, but has not been formally evaluated. The aim of this study was to

develop and validate the first HBV stigma instrument and to begin to evaluate

HBV stigma in Chinese immigrants. The HBV stigma instrument was developed based

on constructs from validated HIV stigma scales and organized into five domains.

A written survey was compiled to include demographic data, HBV knowledge

questions and stigma items. The survey was pilot tested in English and Chinese

and then finalized. Data were obtained from 201 patients seen in an urban

Chinatown Internal Medicine practice. The stigma items showed a high degree of

reliability when assessed in aggregate (Î± = 0.85) as well as within individual

domains. Stigma was greatest in the Fear of Contagion domain. Knowledge

questions showed a corresponding deficit in understanding of modes of HBV

transmission. An inverse relationship between stigma scores and familiarity with

HBV provided evidence of construct validity. In multivariable analysis, having a

family member with HBV and higher HBV knowledge subset scores were associated

with lower degrees of stigma. In conclusion, the hepatitis B stigma instrument

showed reliability and construct validity. The relationship identified between

familiarity and knowledge regarding HBV with lower stigma scores provides the

basis for the development of interventions to reduce HBV stigma.

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