Hepatitis B knowledge and stigma in the United Arab Emirates

Globally, there are 1.2 million new chronic Hepatitis B Virus (HBV) infections every year. The UAE is a low-endemic region where no previous studies have explored HBV stigma. This study aims to evaluate the UAE's population HBV knowledge, HBV vaccine attitudes, and stigmatizing attitudes towards the HBV infection. A cross-sectional study was conducted to evaluate knowledge and stigma; the previously-developed and validated stigma scale (Hepatitis B Virus - Stigma Scale, HBV-SS) was used. A total of 601 responses were retained for analysis in both python-3 and R. Chi-squared, Mann-Whitney U and Kruskal-Wallis tests were used for bivariate analyses and ordinary least squares (OLS) regression was used for linear modelling. Confirmatory factor analysis (CFA) was conducted, and goodness-of-fit was evaluated. Overall, 77.5%, (n = 466/601) reported having some knowledge regarding HBV, only 19.3% (n = 90/466) had good knowledge regarding HBV, with most gaps occurring with symptoms, complications, and treatment of the infection. However, 84.03% (n = 505/601) were interested in learning more about the virus. Only 57.6% (n = 346/601) were aware of the existence of the vaccine; however, attitudes to it were overwhelmingly positive. Overall, non-stigmatising attitudes dominated; however, both labelling and separating domains highlighted specific items with highly stigmatising attitudes. CFA showed the HBV-SS model to have acceptable/good goodness-of-fit. OLS identified higher knowledge levels among healthcare workers and those with higher perceived knowledge. Only perceived knowledge was a significant predictor of lower stigma beyond the bivariate level. The UAE population has shown low levels of knowledge but overall non-stigmatising attitudes. It is imperative that campaigns focus on improving general population HBV infection and vaccine knowledge while also solidifying the widespread level of vaccine acceptance and non-stigmatising attitudes.