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2.
Int J Environ Res Public Health ; 18(24)2021 12 12.
Article in English | MEDLINE | ID: covidwho-1572464

ABSTRACT

The populations impacted most by COVID are also impacted by racism and related social stigma; however, traditional surveillance tools may not capture the intersectionality of these relationships. We conducted a detailed assessment of diverse surveillance systems and databases to identify characteristics, constraints and best practices that might inform the development of a novel COVID surveillance system that achieves these aims. We used subject area expertise, an expert panel and CDC guidance to generate an initial list of N > 50 existing surveillance systems as of 29 October 2020, and systematically excluded those not advancing the project aims. This yielded a final reduced group (n = 10) of COVID surveillance systems (n = 3), other public health systems (4) and systems tracking racism and/or social stigma (n = 3, which we evaluated by using CDC evaluation criteria and Critical Race Theory. Overall, the most important contribution of COVID-19 surveillance systems is their real-time (e.g., daily) or near-real-time (e.g., weekly) reporting; however, they are severely constrained by the lack of complete data on race/ethnicity, making it difficult to monitor racial/ethnic inequities. Other public health systems have validated measures of psychosocial and behavioral factors and some racism or stigma-related factors but lack the timeliness needed in a pandemic. Systems that monitor racism report historical data on, for instance, hate crimes, but do not capture current patterns, and it is unclear how representativeness the findings are. Though existing surveillance systems offer important strengths for monitoring health conditions or racism and related stigma, new surveillance strategies are needed to monitor their intersecting relationships more rigorously.


Subject(s)
COVID-19 , Racism , Humans , SARS-CoV-2 , Social Stigma
3.
BMC Public Health ; 21(1): 1958, 2021 10 29.
Article in English | MEDLINE | ID: covidwho-1561729

ABSTRACT

BACKGROUND: Stigma associated with infectious diseases is common and causes various negative effects on stigmatized people. With Wuhan as the center of the COVID-19 outbreak in China, its people were likely to be the target of stigmatization. To evaluate the severity of stigmatization toward Wuhan people and provide necessary information for stigma mitigation, this study aimed to identify the stigmatizing attitudes toward Wuhan people and trace their changes as COVID-19 progresses in China by analyzing related posts on social media. METHODS: We collected 19,780 Weibo posts containing the keyword 'Wuhan people' and performed a content analysis to identify stigmatizing attitudes in the posts. Then, we divided our observation time into three periods and performed repeated-measures ANOVA to compare the differences in attitudes during the three periods. RESULTS: The results showed that stigma was mild, with 2.46% of related posts being stigmatizing. The percentages of stigmatizing posts differed significantly during the three periods. The percentages of 'Infectious' posts and 'Stupid' posts were significantly different for the three periods. The percentage of 'Irresponsible' posts was not significantly different for the three periods. After government interventions, stigma did not decrease significantly, and stigma with the 'Infectious' attitude even increased. It was not until the government interventions took effect that stigma significantly reduced. CONCLUSIONS: This study found that stigma toward Wuhan people included diverse attitudes and changed at different periods. After government interventions but before they took effect, stigma with the 'Infectious' attitude increased. After government interventions took effect, general stigma and stigmas with 'Infectious' and 'Stupid' attitudes decreased. This study constituted an important endeavor to understand the stigma toward Wuhan people in China during the COVID-19 epidemic. Implications for stigma reduction and improvement of the public's perception during different periods of epidemic control are discussed.


Subject(s)
COVID-19 , Epidemics , Social Media , Humans , SARS-CoV-2 , Social Stigma
4.
Psychiatr Danub ; 33(3): 378-385, 2021.
Article in English | MEDLINE | ID: covidwho-1527114

ABSTRACT

Stigma is a convoluted interaction between history, sociology, psychology, medicine, anthropology, and politics. Often, stigma is inter-twined at cognitive-emotional-behavioral level with a socio-cultural-economic-political milieu and hence distinct from prejudice, discrimination or, stereotypy. Stigma against diseases as a concept has evolved and has differed among various illnesses. At this time of humanitarian crisis, it is prudent to understand the concept, elements and models of stigma to tackle stigma against COVID-19 instrumentally. Stigma against COVID-19 can be partially extrapolated from various models described in psychiatry for mental illness. We propose an integrated socio-cognitive-emotional-behavioral model of stigma to conceptualize and understand the stigma against COVID-19, a matter of immense public health significance.


Subject(s)
COVID-19 , Diptera , Mental Disorders , Animals , Cognition , Humans , SARS-CoV-2 , Social Stigma
5.
Afr J Prim Health Care Fam Med ; 13(1): e1-e3, 2021 Oct 28.
Article in English | MEDLINE | ID: covidwho-1524285

ABSTRACT

The Kenyan Ministry of Health envisages that family physicians should play an important role in the implementation of community orientated primary care (COPC) in collaboration with the community health team. The Kenyan Community Health Strategy forms a solid basis for the implementation of the COPC model. Residents and faculty of the Family Medicine department at the Aga Khan University Hospital Nairobi collaborated with the Kaloleni sub-county of Kilifi County government near Mombasa in a five-step COPC process to better understand and act against the high prevalence of HIV stigma in the coastal region. Firstly, a deeper understanding of human immunodeficiency virus (HIV) stigma was acquired through community visits and work in the comprehensive care clinic. Secondly, a collaborative implementation team was formed to design a targeted and feasible intervention. In a participatory approach, a two-step intervention was employed, firstly sensitising healthcare workers and community health volunteers (CHVs) on the high prevalence of HIV stigma in their community and educating them on HIV-related issues. Secondly, the information was disseminated to the community through home visits by CHVs, health talks and the set-up of an HIV support group at the facility. This short report illustrates the important contribution of family physicians to implementation of COPC and capacity building of the primary healthcare team.


Subject(s)
Family Practice , HIV Infections , HIV Infections/therapy , Humans , Kenya , Primary Health Care , Social Stigma
6.
Lancet ; 398(10314): 1871, 2021 11 20.
Article in English | MEDLINE | ID: covidwho-1521618
7.
Int J Environ Res Public Health ; 18(21)2021 11 08.
Article in English | MEDLINE | ID: covidwho-1512321

ABSTRACT

This study aimed to examine the profile of COVID-19-related public stigma and its correlates in the general population of China. A cross-sectional online survey was conducted in China from 7 May to 25 May in 2020. A total of 1212 participants from the general population completed the survey measuring their stigmatizing attitudes towards COVID-19, as well as knowledge and causal attributions of COVID-19. Univariate and multivariate analyses were performed to examine the correlates of COVID-19-related public stigma. A total of 31.8% of participants endorsed stigmatization towards people with COVID-19. Those who were of older age (t = -3.97, p < 0.001), married (F = 3.04, p < 0.05), had a lower level of education (F = 8.11, p < 0.001), and a serious psychological response (F = 3.76, p < 0.05) reported significantly higher scores of public stigma. Dangerousness (B = 0.047, p < 0.001), fear (B = 0.059, p < 0.001), anger (B = 0.038, p < 0.01), and responsibility (B = 0.041, p < 0.001) were positively associated with public stigma. This study shows that public stigma related to COVID-19 is prevalent in the general population of China. Actions against public stigma need to contain the spread of misinformation about COVID-19, alter inappropriate attributions, alleviate unfavorable reactions, and provide psychosocial support for the public.


Subject(s)
COVID-19 , Aged , China , Cross-Sectional Studies , Humans , SARS-CoV-2 , Social Stigma , Surveys and Questionnaires
8.
BMJ Open ; 11(11): e048241, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1501712

ABSTRACT

OBJECTIVE: Amid the COVID-19 pandemic, social stigma towards COVID-19 infection has become a major component of public discourse and social phenomena. As such, we aimed to develop and validate the COVID-19 Public Stigma Scale (COVID-PSS). DESIGN AND SETTING: National-based survey cross-sectional study during the lockdown in Thailand. PARTICIPANTS: We invited the 4004 adult public to complete a set of measurement tools, including the COVID-PSS, global fear of COVID-19, perceived risk of COVID-19 infection, Bogardus Social Distance Scale, Pain Intensity Scale and Insomnia Severity Index. METHODS: Factor structure dimensionality was constructed and reaffirmed with model fit by exploratory and confirmatory factor analyses and non-parametric item response theory (IRT) analysis. Psychometric properties for validity and reliability were tested. An anchor-based approach was performed for classifying the proper cut-off scores. RESULTS: After factor analysis, IRT analysis and test for model fit, we created the final 10-item COVID-PSS with a three-factor structure: stereotype, prejudice and fear. Face and content validity were established through the public and experts' perspectives. The COVID-PSS was significantly correlated (Spearman rank, 95% CI) with the global fear of COVID-19 (0.68, 95% CI 0.66 to 0.70), perceived risk of COVID-19 infection (0.79, 95% CI 0.77 to 0.80) and the Bogardus Social Distance Scale (0.50, 95% CI 0.48 to 0.53), indicating good convergent validity. The correlation statistics between the COVID-PSS and the Pain Intensity Scale and Insomnia Severity Index were <0.2, supporting the discriminant validity. The reliability of the COVID-PSS was satisfactory, with good internal consistency (Cronbach's α of 0.85, 95% CI 0.84 to 0.86) and test-retest reproducibility (intraclass correlation of 0.94, 95% CI 0.86 to 0.96). The proposed cut-off scores were as follows: no/minimal (≤18), moderate (19-25) and high (≥26) public stigma towards COVID-19 infection. CONCLUSIONS: The COVID-PSS is practical and suitable for measuring stigma towards COVID-19 in a public health survey. However, cross-cultural adaptation may be needed.


Subject(s)
COVID-19 , Social Stigma , Adult , Communicable Disease Control , Cross-Sectional Studies , Factor Analysis, Statistical , Humans , Pandemics , Psychometrics , Reproducibility of Results , SARS-CoV-2 , Surveys and Questionnaires
9.
Am J Hum Biol ; 32(5): e23480, 2020 09.
Article in English | MEDLINE | ID: covidwho-1499212

Subject(s)
Pandemics , Social Stigma , Humans
10.
J Emerg Manag ; 18(7): 177-182, 2021.
Article in English | MEDLINE | ID: covidwho-1497639

ABSTRACT

INTRODUCTION: The greatest enemy of a global pandemic is not the virus itself, but the fear, rumor, and stigma that envelopes people. This article explores the context and history of fear and stigma relating to pandemic, summarizing key actions to mitigate the harms during an active pandemic. METHOD: Our article draws from accounts in literature and journalist accounts documenting the relationship between infectious diseases and major disease outbreaks that have garnered fear and stigmatization. RESULTS: Fear, stigma, and discrimination are not new concepts for pandemics. These social effects run the risk of diverting attention from the presenting disease and government responses. Reactions to fear, stigma, and discrimination risk sabotaging effective efforts to contain, manage, and eradicate the disease. CONCLUSION: Emergency managers have an important role in dispelling myths, disseminating appropriate and evidence-based information without exacerbating fears. Knowledge about the roots of fear and bias along with a good understanding of historical plagues and pandemics is vital to ensure those in the field of emergency management can effectively manage irrational fears.


Subject(s)
COVID-19 , Pandemics , Fear , Humans , SARS-CoV-2 , Social Stigma
11.
J Int Med Res ; 48(3): 300060519890819, 2020 Mar.
Article in English | MEDLINE | ID: covidwho-1453007

ABSTRACT

OBJECTIVES: The better-off-dead belief, the idea that death is preferable for people living with human immunodeficiency virus, is a highly devaluing attitude, but little is known about its determinants among the general population. Guided by the instrumental model of stigma, this study examined the contributive roles of fear of infection and social distance to this stigmatizing belief. METHODS: A total of 304 Chinese university students recruited in Guangzhou and Hong Kong responded to questionnaires assessing the better-off-dead belief, fear of infection and social distance. Structural equation modelling was used to test associations among the variables. RESULTS: Fear of infection and social distance were associated with higher levels of the better-off-dead belief. Social distance mediated the association between fear of infection and the better-off-dead belief. CONCLUSIONS: Fear of infection and social distance are determinants of the better-off-dead belief, with social distance serving as a mediator. This study highlights the importance of addressing fear and avoidance in future public health efforts to reduce the prevalence of the better-off-dead belief.


Subject(s)
HIV Infections , Social Stigma , Fear , Humans , Psychological Distance , Surveys and Questionnaires
12.
Int J Tuberc Lung Dis ; 25(10): 869-870, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1478370
13.
J Infect Dev Ctries ; 15(9): 1281-1285, 2021 09 30.
Article in English | MEDLINE | ID: covidwho-1478142

ABSTRACT

INTRODUCTION: The COVID-19 pandemic influences the spirituality and mental health of individuals. It also has caused a global economic recession. COVID-19 is easily transmitted and causes death. Consequently, severe prevention and control measures of COVID 19 are required in this situation. This study aims to analyze the relationship between anxiety, stigma, religiosity, economic conditions, and the prevention of COVID-19. METHODOLOGY: A cross-sectional study was designed. The data collection was taken through online surveys. The population in this study is ninety-two lecturers from the College of Health Sciences and the State Islamic Institute who were chosen using a non-probability snowball sampling technique. Data analysis used logistic regression analysis. RESULTS: The results showed that there was a relationship between anxiety (p = 0.001), stigma (p = 0.008), religiosity (p = 0.005) and the efforts to prevent COVID-19, while economic conditions (p = 0.882) were not related to the preventive efforts. The results of multivariate analysis indicated that the most influential variable affecting COVID-19 preventions was the level of anxiety, with an Odds Ratio of 4.9. CONCLUSIONS: There was a relationship between anxiety, stigma, religiosity, and COVID-19 preventions, while there was no relationship between economic conditions and COVID-19 preventions. The most influencing variable was anxiety. Respondents must be able to manage anxiety levels related to COVID-19 with good coping strategies.


Subject(s)
Anxiety/epidemiology , COVID-19/psychology , Faculty , Social Stigma , Spirituality , Adult , COVID-19/economics , COVID-19/prevention & control , Communicable Disease Control , Cross-Sectional Studies , Female , Humans , Indonesia , Islam , Male , Mental Health , Surveys and Questionnaires
14.
BMC Psychol ; 9(1): 164, 2021 Oct 22.
Article in English | MEDLINE | ID: covidwho-1477467

ABSTRACT

INTRODUCTION: Stigma develops during outbreaks such as the COVID-19 pandemic due to the human fear that arises from the anxiety about a disease of an unknown etiology, with the associated detrimental consequences on both the individual and society. This study was conducted to assess if knowledge about COVID-19, attitude, practice and behavior regarding preventive measures against COVID-19, fear, and anxiety towards COVID-19 will affect the level of stigma and evaluate the mediating effect of fear, anxiety, and diagnosis of COVID-19 on stigma. METHODS: A cross-sectional online survey conducted between December 20, 2020, and January 05, 2021, enrolled 405 participants recruited from the Lebanese population. Two scales were created and adapted to the Lebanese context to measure the current stigma (stigma discrimination scale, self-stigma scale) toward COVID-19. RESULTS: More than half of the sample had moderate to severe stigma discrimination (62%) and self-stigma (65.9%). The multivariable analysis showed that higher fear of COVID-19 scale (Beta = .143) was significantly associated with a higher stigma discrimination scale. Whereas, higher knowledge score (Beta = -.153) was significantly associated with a lower stigma discrimination scale. Fear of COVID-19, anxiety from COVID-19, being diagnosed with COVID-19, and having a family member with COVID-19 partially mediated the association between knowledge and stigma discrimination scale. No mediation effect of fear and anxiety scale was found between the knowledge and self-stigma score. CONCLUSION: Our main findings indicate that a considerable proportion of the Lebanese population has stigma discrimination behaviors toward COVID-19 patients and that those who were infected with the virus experienced COVID-19-related stigmatization.


Subject(s)
COVID-19 , Pandemics , Cross-Sectional Studies , Humans , SARS-CoV-2 , Social Stigma
15.
BMC Infect Dis ; 21(1): 1066, 2021 Oct 14.
Article in English | MEDLINE | ID: covidwho-1468049

ABSTRACT

BACKGROUND: The COVID-19 and HIV epidemics have exacerbated existing inequities among vulnerable groups and severely impacted communities of color. People living with HIV (PLWH), who may already face stigma or discrimination, are at risk of experiencing further stigma as a result of COVID-19, which can result in medical mistrust. METHODS: We performed qualitative interviews between June and August 2020 among 32 PLWH, including 10 individuals diagnosed with COVID-19. A majority of participants perceived themselves as having an increased risk of contracting COVID-19 due to their HIV status. RESULTS: Of those who tested positive for COVID-19, the majority regarded their HIV diagnosis as having a more profound impact on their lives but found similarities between COVID-19 stigma and HIV-related stigma. Many participants also expressed mistrust. CONCLUSIONS: These results can be used to better understand the perspectives of PLWH during the COVID-19 pandemic and have important implications for potential COVID-19 vaccine hesitancy and future health crises.


Subject(s)
COVID-19 , HIV Infections , COVID-19 Vaccines , HIV Infections/diagnosis , HIV Infections/epidemiology , Humans , Pandemics , SARS-CoV-2 , Social Stigma , Trust
17.
Front Health Serv Manage ; 38(1): 32-38, 2021 Oct 01.
Article in English | MEDLINE | ID: covidwho-1455390

ABSTRACT

SUMMARY: Fighting the global COVID-19 pandemic has shifted from immediate response efforts to recognition of the long-term effects on the mental health and well-being of the general population and healthcare workforce. Leaders need to understand the vital role of behavioral health services in a population-based, integrated healthcare framework and address the needs of the behavioral health workforce to successfully deploy services in their organizations and communities.During the ongoing national response to COVID-19, three major trends have emerged: (1) a shift to telehealth and digital care, (2) greater awareness of the impact on the workforce of the shift to digital care, and (3) an open dialogue to counteract the stigma and discrimination related to mental illness and to emphasize mental well-being instead. When they address stigma and discrimination, healthcare leaders embrace a more holistic approach that welcomes behavioral health professionals as equal, vital members of the care team. They help their organizations advance the mental well-being of all.


Subject(s)
COVID-19/psychology , COVID-19/therapy , Health Personnel/psychology , Health Promotion/organization & administration , Mental Disorders/therapy , Mental Health Services/organization & administration , Social Stigma , Telemedicine/organization & administration , Adult , Attitude of Health Personnel , Female , Humans , Male , Middle Aged , Organizational Objectives , Pandemics , SARS-CoV-2 , United States
18.
Community Ment Health J ; 57(1): 144-152, 2021 01.
Article in English | MEDLINE | ID: covidwho-1453785

ABSTRACT

This Is My Brave (TIMB) is a contact-based mental illness stigma reduction program set in theaters. A randomized controlled trial of TIMB, compared the effect of TIMB videos to a comparison and control condition video. Pre- and post-surveys (153 adults) assessed mental illness stigma, beliefs about recovery and empowerment, and willingness to seek treatment. Univariate ANCOVAs revealed participants in the TIMB video condition experienced a greater reduction in perceived difference from people with mental illnesses than the comparison and control groups. Participants in the comparison and TIMB video conditions experienced greater reductions in social distance than the control group. Contrary to our hypothesis, participants in the TIMB video condition did not endorse improved beliefs about recovery and empowerment as compared to the comparison and control groups. These findings provide evidence for TIMB as an effective program for stigma reduction, particularly reducing perceived difference from people with mental illnesses and decreasing desired social distance.


Subject(s)
Communication , Mental Disorders , Social Stigma , Adult , Humans , Mental Disorders/therapy , Narration , Surveys and Questionnaires
19.
PLoS One ; 16(10): e0258042, 2021.
Article in English | MEDLINE | ID: covidwho-1448577

ABSTRACT

OBJECTIVE: To investigate the perceived-stigma level of COVID-19 patients in the early stage of the epidemic and analysed related factors and correlations that affected the stigma levels. METHODS: The COVID-19 patients were selected using the convenience sampling method. Perceived-stigma level was evaluated using the Social Impact Scale (SIS). Frequency was used to describe the general information and disease investigation status of COVID-19 patients; mean and standard deviation were used for describing stigma levels, Wilcoxon signed-ranks test (nonparametric test) was applied for pairwise comparison. Kruskal-Wallis non-parametric test for grade data, and Dwass-Steel-Critchlow-Fligner test for multiple comparative analysis. Multiple linear regression analysis was performed, and statistically significant indicators in single-factor analysis were included to investigate the independent factors of stigma. The p<0.05 was considered statistically significant. RESULTS: SIS score of the 122 COVID-19 patients averaged 57.37±9.99 points. There were statistically significant differences in perceived-stigma levels among patients of different ages (p = 0.008), occupation (p <0.001), marital status (p = 0.009), and disease severity (p = 0.020). Multivariate logistic regression analysis revealed that age was the main influencing factor of stigma (p<0.05). CONCLUSIONS: The overall perceived-stigma level of COVID-19 patients in the early stage of the epidemic was moderate. Younger, unmarried, and severely ill patients had a higher level of perceived-stigma, with age being the main factor. More attention should be given to the young COVID-19 patients.


Subject(s)
COVID-19/pathology , Social Stigma , Adult , Age Factors , COVID-19/epidemiology , COVID-19/virology , China/epidemiology , Cross-Sectional Studies , Humans , Linear Models , Male , Marriage , Middle Aged , SARS-CoV-2/isolation & purification , Severity of Illness Index , Surveys and Questionnaires
20.
Brain Behav Immun ; 99: 17-24, 2022 01.
Article in English | MEDLINE | ID: covidwho-1432971

ABSTRACT

The debate around Long Covid has so far shown resistance to accept parallels between Long Covid and a set of existing conditions which have historically been subject to stigma. This resistance risks endorsing the stigma associated with such existing conditions, and as such, these dynamics of stigma ought to be dismantled in order to facilitate the development of effective clinical resources for all such implicated conditions. As well as affecting proceedings at the structural level, I discuss how the aforementioned problems also risk affecting patients at the personal level by motivating the reconfiguration and restriction of patient illness narratives. The problems I identify therefore risk affecting both collective and individual understanding of Long Covid.


Subject(s)
COVID-19 , Attitude , COVID-19/complications , Humans , SARS-CoV-2 , Social Stigma
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