COVID-19-related stigma and its' influencing factors: a rapid nationwide study in China (preprint)

ABSTRACT

Background：COVID-19 poses a significant challenge to global public health. During the pandemic, COVID-19 patients and people in outbreak areas have suffered from stigma associated with the disease. This study aimed to evaluate the prevalence of COVID-19-related stigma toward COVID-19 patients and people from the city of Wuhan in China and assess the association of COVID-19-related stigma, health literacy, and sociodemographic characteristics.Methods：A cross-sectional survey covering 5,039 respondents was conducted in 31 provinces in China using a convenience sampling method. Binary logistic regressions were used to identify the factors associated with COVID-19-related stigma.Results：Among the participants, 122 (2.4%) reported themselves and 254 (5.0%) reported the communities they lived in held a stigmatizing attitude toward COVID-19 patients, respectively. Additionally, 114 (2.5%) and 475 (10.3%) reported that themselves and the communities they lived in, respectively, held a stigma against people from Wuhan, where was the most severely affected area in China. People aged over 40, lived in areas with severe epidemics (aOR=2.15, 95% CI [1.12-4.13]), and who felt it difficult to find and understand information about COVID-19 (aOR=1.91, 95% CI [1.08-3.27]; aOR=1.88, 95% CI [1.08-3.29]) were more likely to stigmatize COVID-19 patients. People who were male, aged 41 to 50, and had difficulty understanding information (aOR=2.08, 95% CI [1.17-3.69]) were more likely to stigmatize people from Wuhan.Conclusions：COVID-19 patients and Wuhan residents suffered stigma at both the individual and community levels, although proportion of those holding a stigma was not very high. Provinces close to Wuhan had relatively high stigma toward COVID-19 patients and people from Wuhan. There was a correlation between better health literacy and lower stigma during the COVID-19 outbreak. Tailored interventions were encouraged to improve health literacy and consequently to reduce stigma toward both COVID-19 patients and Wuhan people from individual and community levels, respectively.