Authors:

Alba Rocco, Luigi Pisciotta,Rosa Clavo, Debora Compare, Gerardo Nardone

Affiliations:

Department of Clinical Medicine and Surgery, Gastroenterology and Hepatology Unit, Federico II University of Naples

Background and aims:

Stigmatization refers to a person or group’s exclusion, rejection, guilt or devaluation due to a negative and medically unwarranted judgment. Stigma can be “social”, “perceived”, and “institutional” and represents an important issue for many chronic diseases, especially those with infectious aetiology. Hepatitis B virus (HBV) infection is one of the most common diseases worldwide. However, the impact of stigmatization in patients with chronic HBV infection is still scarcely investigated. This study aimed to evaluate the level of knowledge and degree of social and perceived stigmatization in patients with chronic HBV infection.

Methods:

A validated questionnaire assessing the level of knowledge on chronic HBV infection and the degree of stigmatization related to infection was fullfilled by 90 patients with chronic HBV infection and 102 healthy controls (HC). The questionnaire included three sections: the first on demographic information, the second containing information related to transmission, evolution and management of the infection, and the last section assessing the degree of stigma and discrimination perceived by patients or against affected patients by exploring four domains: interpersonal relationships, physical contact, workplace and disease perception.

Results:

Male sex was prevalent in both HBV and HC groups (65% vs 55%, respectively). HBV patients were significantly older than HC (60 years vs 42 years; p <0.001) and married more frequently than HC (78% vs 47% respectively, p = 0.003). HBV patients had a primary school education more frequently than HC (53% vs 8%, respectively, p<0.001), while HC were more frequently actively working than HBV patients (77% vs 49%, p = 0.003). The overall score on knowledge of the disease was significantly higher in HBV than HC group (11.9 vs 9.3; p < 0.0001). In the section assessing the degree of perceived or social stigma, the mean overall score was significantly higher in HBV than that reported by HC (18 vs 16; p = 0.0234). Patients had higher scores than HC in all individual domains (interpersonal relations, physical contact, employment, workplace and perception of illness).

Conclusions:

In conclusion, our study demonstrated that knowledge of HBV infection is scarce, especially among younger groups of the healthy population, and the disease is associated with perceived and social stigmatization. Awareness initiatives by healthcare professionals and institutions are necessary to overcome the stigma related to HBV and the barrier that it represents to access screening and therapy.

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