The Impact Of Hepatitis B Knowledge and Stigma on Screening in Canadian Chinese Persons

Li, Dorothy; Tang, Tao; Patterson, Matt; Ho, Michael; Heathcote, Jenny; Shah, Hemant

doi:10.1155/2012/705094

Cited by 74 publications

(145 citation statements)

References 26 publications

(21 reference statements)

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“…;" and "Do you think parents should accept their child marrying a hepatitis B-infected person?." Participants were given 3 options, "yes" (0), "it depends" (1) and "no" (2). Their answers were summed over the 5 questions for each participant, with higher scores indicating higher levels of sigma.…”

Section: Definition and Measurement Of Dependent Variablesmentioning

confidence: 99%

“…1 In 2012, there were an estimated 350-400 million carriers of chronic hepatitis B infection. 2 In China, HBV remains a particularly challenging public health issue, with an estimated 90 million chronic hepatitis B virus carriers, which accounts for almost 7% of the Chinese population (WHO, 2015). Every year, an estimated 300000 people die from HBV-related diseases in China.…”

Section: Introductionmentioning

confidence: 99%

“…11 Discrimination and HBV stigma underpinned the reluctance of HBV carriers to access HBV screening, diagnosis, care and treatment services and also a barrier to adopting prevention behaviors. 2,12 There have been limited studies of discrimination against HBV patients. Cultural values and social-cognitive factors are known to affect HBV-related discrimination, 13 and discrimination studies have identified education as an important stigmareduction intervention.…”

Section: Introductionmentioning

confidence: 99%

“…Ranked third in China as a rural worker destination, 38% of Beijing's 2013 population of 21.1 million is accounted for by migrant workers. 16 With higher rates of chronic hepatitis B infection than the urban-born population, 2 and different age, gender, education and attitudinal characteristics than urban-born residents, rural migrants form a unique urban subgroup. For this rural migrant subgroup in Beijing, our study evaluates the factors accounting for discrimination against HBV patients and carriers in their everyday life, and suggests policy responses to attenuate such discrimination.…”

Section: Introductionmentioning

confidence: 99%

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Hepatitis B discrimination in everyday life by rural migrant workers in Beijing

Leng

Wangen

et al. 2016

Human Vaccines & Immunotherapeutics

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Background: In China, the hepatitis B virus (HBV) is a particularly challenging public health issue, with an estimated 90 million chronic hepatitis B carriers accounting for almost 7% of the population. Healthrelated discrimination can serve as a barrier to prevention and care for infectious diseases, such as HBV, degrade the HBV sufferers' quality of life and limit HBV patients' employment opportunities. While rural migrants account for up to 40% of the total urban population in the developed cities in China, there has been no study of the discrimination behavior of rural migrant workers toward HBV carriers.Objective: This study evaluates the discrimination behavior of rural migrant workers toward HBV carriers and patients and proposes public policy recommendations to address discrimination and stigma.Methods: The sample comprised 903 rural adults, aged over 18 years old, who migrated to Beijing. Using a face-to-face interview, we surveyed rural migrants' demographic characteristics, knowledge of HBV and discrimination against HBV carriers. Descriptive statistics were used to characterize the study population, HBV stigma and knowledge of HBV. Three discrimination levels (no-mild, medium and severe discrimination) were modeled using multiple logistic regression.Results: Rural migrants to Beijing had a mean age of 36 years, were overwhelmingly married (91.58%), mostly with a junior high school or lower education (78.05%) and mainly engaged as temporary workers (42.52%) or self-employed (33.78%). Only 30.56% reported that they had been vaccinated against HBV. On the 0-10 discrimination scale, rural migrants rated 6.24, with only 4.54% displaying no sign of HBV-related discrimination. The high discrimination score occurred alongside a low mean knowledge of HBV (7.61 on the 1-22 ranking of HBV knowledge). Multiple logistic regression results suggest an inverse relationship between discrimination levels and HBV knowledge, especially knowledge about treatment and transmission routes. The "fear of being infected with HBV" and being HBV vaccinated was positively associated with HBV-related discrimination. Unemployed rural migrants were more likely to exhibit severe HBV-related discrimination than other occupational groups. Personal attributes, such as gender, age, marital status and education level were not associated with the level of discrimination.Conclusions: Knowledge of HBV, its transmission and treatment, and the fear of HBV infection were key features in understanding HBV discrimination by rural migrant workers. To reduce discrimination, HBV public health education campaigns need to focus on both knowledge about HBV and the fear of HBV infection. Such campaigns should target rural migrant subgroups, such as unemployed rural migrant workers.

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Section: Definition and Measurement Of Dependent Variablesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Hepatitis B discrimination in everyday life by rural migrant workers in Beijing

Leng

Wangen

et al. 2016

Human Vaccines & Immunotherapeutics

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“…Hepatitis knowledge has been demonstrated to be associated with disease management and outcomes, with improved management and outcomes among those with increased knowledge of the disease [8,9]. Further, as knowledge of transmission improves, rates of disease screening and incidence have been shown to decrease [10].…”

mentioning

confidence: 99%

Correlates of disease-specific knowledge among patients with chronic hepatitis B or hepatitis C infection in India

et al. 2016

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Background Patient knowledge about chronic diseases increases health-promoting behaviors and improves clinical outcomes. We assessed this association for patients with chronic viral hepatitis. Methods Untreated patients chronically infected with HBV (n = 500) or HCV (n = 500) were enrolled at 19 centers across India. A survey, adapted from the US CDC National Health and Nutrition Examination Survey (NHANES) questionnaire, was administered at a single visit to assess HBV/HCV knowledge, community disease awareness, treatment quality, and healthcare barriers. We developed the India Hepatitis Knowledge Index (IHKI), where a higher IHKI score (range 0-10) indicates increased hepatitis knowledge. Multivariate regression models evaluated demographic and disease factors. Results The overall mean IHKI score was 5.6 out of 10, with higher scores among patients with HBV (5.9) than HCV (5.3); p \ 0.001. In HBV patients lower IHKI was associated with shorter disease duration, government clinic attendance (p \ 0.0001), fewer personal experiences with HBV (p \ 0.0001), and residing in northern India. Among HCV patients, lower IHKI was associated with shorter disease duration, community (p \ 0.0001) and government clinic attendance (p \ 0.0001), and fewer personal experiences with HCV (p \ 0.0001). Among HBV patients, IHKI was independently associated with disease severity as assessed by MELD score, albumin, and APRI. This association was strongest for HBV patients with elevated ALT and HBV DNA [2000 IU/ml. Among HCV patients, IHKI results had no significant associations with disease severity. Conclusions The association of IHKI with disease underscores the need to understand connections between hepatitis knowledge and progression and may guide efforts to address patient education and awareness of chronic viral hepatitis in India.

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Diagnosis Rates of Chronic Hepatitis B in Privately Insured Patients in the United States

et al. 2020

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IMPORTANCE To achieve the World Health Organization goal of viral hepatitis elimination by 2030, it is important to estimate current rates of chronic hepatitis B (CHB) diagnosis and treatment. OBJECTIVE To provide an accurate accounting of the number of patients with CHB aged 6 years or older who have not yet been diagnosed in the United States. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used the commercial US Truven Health MarketScan Database (138 634 154 privately insured individuals in January 2007 to December 2014) to identify patients with CHB diagnosis and the National Health and Nutrition Examination Survey to estimate the actual number of privately insured persons with CHB. Based on sex and age distribution derived from the US Census Bureau, we calculated the total population with CHB and the proportion of those who remained undiagnosed among the 198 073 302 privately insured individuals. Next, we identified diagnosed CHB patients who received 1 or more prescription for CHB medications to calculate the treatment rate for those with severe disease states, such as cirrhosis and hepatocellular carcinoma, that would warrant treatment. Analyses were performed from October 2017 to January 2020. MAIN OUTCOMES AND MEASURES The rate and number of patients with CHB who remained undiagnosed and treatment rates for patients with CHB who have cirrhosis or hepatocellular carcinoma. RESULTS Among the 198 073 302 privately insured individuals (48.55% male; 15.52% aged 6-17 years; 84.48% aged Ն18 years), there were 511 029 (95% CI, 317 733-704 325) individuals with CHB, but only 95 075 of these had been diagnosed, yielding a diagnosis rate of only 18.60% (95% CI, 13.50%-29.92%), meaning that 81.40% (95% CI, 70.08%-86.50%) were undiagnosed. The treatment rates were 34.79% (95% CI, 33.31%-36.27%) for those with cirrhosis and 48.64% (95% CI, 45.59%-51.69%) for those with hepatocellular carcinoma. CONCLUSIONS AND RELEVANCE In this study, only approximately 1 in 5 privately insured patients with CHB had been diagnosed. Only one-third of patients with CHB who had cirrhosis and one-half who had hepatocellular carcinoma received antiviral therapy. Further efforts are needed to improve the current situation of poor connection to care for patients with CHB, especially for those with advanced liver disease.

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The Impact Of Hepatitis B Knowledge and Stigma on Screening in Canadian Chinese Persons

Abstract: HBV stigma is associated with reduced rates of screening for this infection.

Cited by 74 publications

References 26 publications

Hepatitis B discrimination in everyday life by rural migrant workers in Beijing

Hepatitis B discrimination in everyday life by rural migrant workers in Beijing

Correlates of disease-specific knowledge among patients with chronic hepatitis B or hepatitis C infection in India

Diagnosis Rates of Chronic Hepatitis B in Privately Insured Patients in the United States

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