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Published on: December 15, 2023
Stigma among healthcare workers towards hepatitis B infection in Bangalore, India: a qualitative study
F C van der Scheun1, M C M Nagelkerke2, A Kilaru3
1University of Groningen, Faculty of Medical Sciences, Antonius Deusinglaan 1, 9713, AV, Groningen, the Netherlands. f.vanderscheun@gmail.com.
Insights
Hepatitis B (HBV) stigma among healthcare workers in India is linked to morality and lack of awareness, impacting patient care. Addressing these issues is crucial for effective HBV management in India.
Area of Science:
- Hepatology
- Public Health
- Sociomedical Sciences
Background:
- High burden of Hepatitis B Virus (HBV) infection in India, affecting approximately 50 million people.
- Stigma significantly hinders screening, diagnosis, and treatment of HBV patients.
- Limited research on HBV stigma within India, particularly among healthcare professionals.
Purpose of the Study:
- To assess the prevalence and nature of stigma associated with Hepatitis B Virus (HBV) among nurses and physicians in Bangalore, India.
- To explore the impact of stigma on the care of HBV patients from the perspective of healthcare workers.
- To identify barriers and facilitators in managing HBV patients in the Indian context.
Main Methods:
- Qualitative study employing semi-structured in-depth interviews.
- Conducted between March 20th and April 16th, 2018, in Bangalore, India.
- Purposive and snowball sampling of 30 physicians and nurses until theoretical saturation.
Main Results:
- Identified key themes: patient interaction, pregnancy/marriage, confidentiality, morality, care improvement, and comparison with HIV.
- Morality emerged as the theme with the most significant stigma.
- Lack of patient awareness identified as the primary obstacle to effective Hepatitis B healthcare.
Conclusions:
- First qualitative study in India examining Hepatitis B stigma among healthcare workers.
- Stigma exists, particularly concerning morality, but no unwillingness to treat was observed.
- Widespread patient unawareness poses a risk to proper HBV treatment; addressing this is vital for future strategies.
Background:
With about 50 million people infected with hepatitis B (HBV) in India the burden of disease is high. Stigma has been identified to have a major negative impact on screening, diagnosis and treatment of hepatitis B patients. The aim of this study was to assess the stigma in nurses and physicians in Bangalore, India; studies on stigma in HBV have only been published outside of India.
Methods:
Semi-structured in-depth-interviews were conducted in the period of March 20th and April 16th 2018 to study stigma and other problems in the care of hepatitis B patients. Stigma was pragmatically defined as a mark of disgrace associated with having a hepatitis B infection. Thirty physicians and nurses in different clinics and hospitals across the city of Bangalore were selected by purposeful sampling and snowball effect until theoretical saturation was reached.
Results:
The following themes were identified during the interviews: feelings when treating a patient; pregnancy and marriage; confidentiality; morality; improvement in care and the difference with HIV. The most stigma was discovered in the theme morality. The majority of our participants mentioned lack of awareness as biggest obstacle in health care of hepatitis B patients.
Conclusions:
This is the first qualitative study in India exploring hepatitis B stigma among health care workers. Stigma was found in certain themes, such as morality. Though, no unwillingness to treat was found. There was a general lack of awareness amongst patients according to our participants and could jeopardize proper treatment. These results will further help in developing strategies to tackle hepatitis B in India.
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