Tuberculosis and COVID-19 Related Stigma: Portuguese Patients Experiences

Tuberculosis (TB)-related stigma has been well-documented. Since the emergence of the coronavirus disease 2019 (COVID-19), different organizations have been alerted to the fact that stigma could arise again. Due to stigma's negative effects, this qualitative study aimed to explore the stigma felt by patients by evaluating the following: COVID-19 stigma and its temporal progression through the pandemic; stigma perceived by different patients with TB before and during COVID-19 pandemic; and difference perceived by individuals who contracted both diseases.

A semi-structured interview was developed according to the available literature on the theme. It was performed individually in 2022 upon receiving signed informed consent. Participants were recruited with a purposive sampling approach by searching medical records. Those who currently or previously had pulmonary TB and/ or COVID-19 were included. Data were subjected to thematic analysis.

Nine patients were interviewed, including six (66.7%) females. The median age of patients was 51±14.7 years. Four participants (44.4%) had completed high school and four (44.4%) were never smokers. Three had both TB and COVID-19. Four only had TB and two only had COVID-19. Interviews identified eight main themes: knowledge and beliefs, with several misconceptions identified; attitudes towards the disease, varying from social support to exclusion; knowledge and education, assumed as of extreme importance; internalized stigma, with self-rejection; experienced stigma, with discrimination episodes; anticipated stigma, modifying actions for avoiding stigma; perceived stigma, with judgment by others prevailed; and temporal evolution of stigma.

Individuals expressed strong stigma for both diseases. De-stigmatization of respiratory infectious diseases is crucial for limiting stigma's negative impact.