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Measuring Hepatitis B-related Stigma: A Systematic Review of Questionnaire-based Studies
Jaconiah Shelumiel T Manalaysay1,2, Diego Nathaniel D Mina2, Brian Arth M Urbano2
1Department of Sociology and Behavioral Sciences, College of Liberal Arts, De La Salle University Manila.
Acta Medica Philippina
|November 3, 2025
Summary
Stigma hinders Hepatitis B management, especially in the Philippines. This review highlights the need for better tools to measure Hepatitis B (HBV) stigma, informing the development of a culturally relevant instrument.
Area of Science:
- Public Health
- Health Psychology
- Sociology
Background:
- Social stigma significantly impedes public health efforts, particularly for prevalent diseases like Hepatitis B (HBV).
- Stigma associated with HBV limits patient access to care and treatment adherence, worsening disease burden.
- A critical gap exists in the systematic evaluation of tools used to measure HBV-related stigma.
Purpose of the Study:
- To systematically review existing instruments measuring Hepatitis B-related stigma.
- To evaluate the methodologies, reliability, and validity of these measurement tools.
- To inform the development of a refined stigma measurement tool tailored for the Philippine context.
Main Methods:
- A systematic literature search was conducted across six databases (PubMed, Cochrane, Open Grey, DissOnline, PHRR, HERDIN) adhering to PRISMA guidelines.
- Quantitative and mixed-methods studies utilizing questionnaires for HBV stigma and discrimination measurement were included.
- Studies published between 1992 and 2023 were screened for relevance based on predefined eligibility criteria.
Main Results:
- The review analyzed 17 articles, identifying 15 unique measurement instrumentations for HBV stigma.
- Most studies used cross-sectional designs and were concentrated in Asia, with a lack of specificity regarding the type of stigma measured.
- While Likert scales were common, few instruments provided cut-off values; 12 articles reported validity and reliability testing.
Conclusions:
- Existing instruments for measuring HBV stigma often lack universal methodology and specificity.
- There is an urgent need for standardized, reliable, and culturally sensitive questionnaires to assess HBV stigma.
- Developing such tools is crucial for effective public health strategies and improved outcomes for individuals with HBV in the Philippines.
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