Perceived stigma related to TB preventive therapy

Abstract

BACKGROUND: TB preventative therapy (TPT) is crucial for reducing the burden of TB in endemic settings. We assessed stigma associated with TPT and the social groups from whom stigma was anticipated.METHODS: We conducted an anonymous cross-sectional survey of community-dwelling adults in rural South Africa. Descriptive statistics, exploratory factor analysis, χ2 tests, Kruskal–Wallis tests, and Poisson regression were used to identify factors associated with TPT stigma.RESULTS: The mean age of the 104 participants was 35 years, 65% were female, and 26% had completed secondary school. The vast majority perceived stigma associated with TPT (71%; mean score 1.7, SD ± 1.4). Factor analysis identified a two-factor solution that explained 61.9% of the variance. Being single (P < 0.001), previously screened for TB (P = 0.04), worried about being infected by TB (P = 0.006), and interested in taking TPT (P = 0.01) were associated with higher perceived stigma scores. TPT stigma was perceived among 8%, 16%, and 66% of their family, friends, and other community members, respectively.CONCLUSION: The prevalence of TPT-related stigma in a rural South African community was high. Community members anticipated less stigma from family members compared to other social groups. Global expansion and implementation of TPT will require novel interventions, such as engaging patients´ families to support uptake and promote adherence.

Tuberculosis Preventive Treatment Update — U.S. President’s Emergency Plan for AIDS Relief, 36 Countries, 2016–2023

“…Lower TPT completion rates have been found to be associated with perceived stigma ( 4 ), which might be higher among those recently diagnosed with HIV ( 5 ). High levels of stigma related specifically to TPT have also been documented ( 6 ), and other barriers to TPT completion such as pill burden ( 7 ), lack of health education, and distance to health facilities ( 8 ) can affect ART-naive clients differently.…”

“…stigma related specifically to TPT have also been documented (6), and other barriers to TPT completion such as pill burden (7), lack of health education, and distance to health facilities (8) can affect ART-naive clients differently.…”