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. 2019 Feb 15;17(1):17.
doi: 10.1186/s12916-019-1250-8.

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

Jeremy C Kane  1 , Melissa A Elafros  2 , Sarah M Murray  3 , Ellen M H Mitchell  4 , Jura L Augustinavicius  3 , Sara Causevic  5 , Stefan D Baral  6
Affiliations

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

Jeremy C Kane et al. BMC Med. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Depression; Epilepsy; HIV; Low- and middle-income countries; Scoping review; Stigma; Substance use; Tuberculosis.

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Conflict of interest statement

Authors’ information

JCK is Assistant Scientist, SMM is an Assistant Professor, and JLA is a postdoctoral research fellow in the Department of Mental Health at Johns Hopkins Bloomberg School of Public Health (JHSPH). SDB is Associate Professor in the Department of Epidemiology at JHSPH. MAE is a resident physician in the Department of Neurology at Johns Hopkins University. EMHM is a senior epidemiologist with the KNCV Tuberculosis Foundation. SC is a PhD student at the Department of Public Health Sciences at Karolinska Institutet.

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Characteristics of included studies
Fig. 2
Fig. 2
Number of studies included by date of publication
See this image and copyright information in PMC

References

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