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. 2024 May;31(5):248-254.
doi: 10.1111/jvh.13932. Epub 2024 Feb 26.

Racial discrimination, knowledge, and health outcomes: The mediating role of hepatitis B-related stigma among patients with chronic hepatitis B

Julia G Katcher  1 , Ann C Klassen  2 , Hie-Won Hann  3 , Mimi Chang  4 , Hee-Soon Juon  5
Affiliations

Racial discrimination, knowledge, and health outcomes: The mediating role of hepatitis B-related stigma among patients with chronic hepatitis B

Julia G Katcher et al. J Viral Hepat. 2024 May.

Abstract

It is well described in current literature that Hepatitis B virus (HBV) affects Asian Americans more than any other racial group in the United States and that there is a stigma attached to this condition. The effects of stigma can be lasting, penetrating physiologically and psychologically, yet few studies have focused on the consequences of this phenomenon. The purpose of this study was to examine the mediating role of stigma in the effect of racial discrimination and knowledge (of HBV sequelae) on health status of Korean Americans with chronic hepatitis B (CHB). Three hundred sixty-five CHB patients were recruited and enrolled from two clinics in Philadelphia and Los Angeles. Depressive symptoms were measured using the Patient Health Question-9 (PHQ-9), physical health via self-rated health survey and stigma via hepatitis B quality of life (HBQOL)-stigma survey. Perceived racial discrimination and knowledge of CHB sequelae were independent variables. The cohort had an average age of 60.1 years (range 19-84, SD 10.7), 56% were male and 94% were born in South Korea. Mediational analysis found that stigma was a significant mediator between both racial discrimination (indirect effect = .037, Bootstrap 95% CI = [.010-.064]) and sequelae knowledge (indirect effect = .097, Bootstrap 95% CI = [.018-.176]) and depressive symptoms. Stigma also had a direct effect on depressive symptoms (β = .136, p < .01) and self-rated health (β = .018, p < .05). In addition, age, gender, education and employment were related to health outcomes. The findings of this study indicate that HBV-related stigma is an important mediator of mental health outcomes in this population. Future studies should identify other psychosocial factors to develop effective intervention programs to reduce stigma and improve quality of life among CHB patients.

Keywords: Asian; chronic hepatitis B; depression; hepatitis B virus; quality of life.

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Conflict of interest statement

Conflict of Interest

None of the authors have any conflict of interest to report.

Figures

Figure 1.
Figure 1.
Fieldwork Status
Figure 2.
Figure 2.
Conceptual Model of the Mediating Role of Stigma Between Knowledge/Perceived Discrimination and Health Outcomes
See this image and copyright information in PMC

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