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Fear, distress, and perceived risk shape stigma toward Ebola survivors: a prospective longitudinal study.
Antonaccio, Cara M; Pham, Phuong; Vinck, Patrick; Collet, Katharine; Brennan, Robert T; Betancourt, Theresa S.
  • Antonaccio CM; Research Program on Children and Adversity, Boston College School of Social Work, Boston, MA, USA.
  • Pham P; Harvard Medical School and Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Vinck P; Harvard Medical School and Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Collet K; Imperial College London School of Public Health, London, UK.
  • Brennan RT; Research Program on Children and Adversity, Boston College School of Social Work, Boston, MA, USA.
  • Betancourt TS; Women's Studies Research Center, Brandeis University, Waltham, MA, USA.
BMC Public Health ; 21(1): 2066, 2021 11 11.
Article in English | MEDLINE | ID: covidwho-1526618
ABSTRACT

BACKGROUND:

During the 2014-15 Ebola Virus Disease (EVD) epidemic, thousands of people in Sierra Leone were infected with the devastating virus and survived. Years after the epidemic was declared over, stigma toward EVD survivors and others affected by the virus is still a major concern, but little is known about the factors that influence stigma toward survivors. This study examines how key personal and ecological factors predicted EVD-related stigma at the height of the 2014-2015 epidemic in Sierra Leone, and the personal and ecological factors that shaped changes in stigma over time.

METHODS:

Using three waves of survey data from a representative sample in the Western Urban and Western Rural districts of Sierra Leone, this study examines factors associated with self-reported personal stigma toward Ebola survivors (11 items, α = 0.77) among 1008 adults (74.6% retention rate) from 63 census enumeration areas of the Western Rural and Western Urban districts of Sierra Leone. Participants were randomly sampled at the height of the EVD epidemic and followed up as the epidemic was waning and once the epidemic had been declared over by the WHO. Three-level mixed effects models were fit using Stata 16 SE to examine cross-sectional associations as well as predictors of longitudinal changes in stigma toward EVD survivors.

RESULTS:

At the height of the EVD epidemic, female sex, household wealth, post-traumatic stress, EVD-related fear and perceived infection risk are a few of the factors which predicted higher levels of stigma toward survivors. On average, stigma toward EVD survivors decreased significantly as the epidemic declined in Sierra Leone, but female sex, EVD fear, and risk perceptions predicted a slower rate of change.

CONCLUSION:

This study identified key individual and psychosocial characteristics which may predict higher levels of stigma toward infectious disease survivors. Future studies should pursue a better understanding of how personal characteristics and perceptions, including psychosocial distress, fear, and perceived infection risk serve as pathways for stigma in communities affected by infectious disease.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hemorrhagic Fever, Ebola Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Female / Humans Country/Region as subject: Africa Language: English Journal: BMC Public Health Journal subject: Public Health Year: 2021 Document Type: Article Affiliation country: S12889-021-12146-0

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hemorrhagic Fever, Ebola Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Female / Humans Country/Region as subject: Africa Language: English Journal: BMC Public Health Journal subject: Public Health Year: 2021 Document Type: Article Affiliation country: S12889-021-12146-0