Department of Psychiatry, Boston Medical Center, Boston, MA, Department of Psychiatry, Boston University School of Medicine, Boston, MA, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Ukrainian Institute on Public Health Policy Consultant, Kyiv, Ukraine.
Int J Tuberc Lung Dis. 2021 Sep 1;25(9):747-753. doi: 10.5588/ijtld.21.0048.
TB is commonly stigmatized. Correlates of perceived TB stigma have not been assessed specifically among HIV-positive people who inject drugs (PWIDs). It is also unclear how perceived TB stigma intersects with other forms of stigma affecting this population. We aimed to evaluate perceived TB stigma, its correlates and its intersection with HIV and substance use stigma among HIV-positive PWIDs in Ukraine. Among 191 participants at three sites across Ukraine, we assessed stigma scores, socio-demographic, behavioral and health-related variables by TB status (history of active TB infection, history of treatment for latent TB infection LTBI, no history of TB infection). We used self-reported history of LTBI treatment as a proxy for LTBI status. We used ordinary least squares to estimate factors associated with perceived TB stigma. Lower perceived TB stigma scores were associated with LTBI status (adjusted beta (aβ) -0.2, 95% CI -0.3 to 0.0; = 0.032). Higher perceived TB stigma scores were associated with higher substance use stigma scores (aβ 0.1, 95% CI 0.0 to 0.2; = 0.004). Depressive symptoms were common in this sample, although not significantly associated with TB status. History of LTBI treatment appears to impact beliefs about perceived TB stigma. Individuals who endorse higher substance use stigma are more likely to hold stigmatizing perceptions about people with TB. HIV-positive PWIDs with history of active TB infection or LTBI treatment commonly experience mental health distress. This stigma intersection needs further exploration in this population, including of its relation with mental health, to provide further insights for targeted interventions.
结核病通常受到歧视。在感染艾滋病毒的注射吸毒者（PWID）中，尚未专门评估对结核病的感知耻辱与哪些因素有关。目前尚不清楚对结核病的感知耻辱与影响这一人群的其他形式的耻辱感如何相交。我们的目的是评估乌克兰 HIV 阳性 PWID 中对结核病的感知耻辱及其相关性，以及与 HIV 和药物使用耻辱的交叉情况。在乌克兰三个地点的 191 名参与者中，我们根据结核病状况（活动性结核病感染史、潜伏性结核病感染治疗史、无结核病感染史）评估了耻辱感评分、社会人口统计学、行为和健康相关变量。我们使用自我报告的潜伏性结核病感染治疗史作为潜伏性结核病感染状况的替代指标。我们使用普通最小二乘法估计与感知结核病耻辱感相关的因素。感知结核病耻辱感评分较低与潜伏性结核病感染状况相关（调整后的β（aβ）为-0.2，95%CI-0.3 至 0.0；P=0.032）。感知结核病耻辱感评分较高与更高的药物使用耻辱感评分相关（aβ 0.1，95%CI 0.0 至 0.2；P=0.004）。尽管在这个样本中抑郁症状很常见，但与结核病状况没有显著关联。潜伏性结核病感染治疗史似乎会影响对感知结核病耻辱感的看法。那些认可更高药物使用耻辱感的人更有可能对结核病患者持有歧视性看法。有活动性结核病感染或潜伏性结核病感染治疗史的 HIV 阳性 PWID 通常会经历心理健康困扰。在这一人群中，需要进一步探讨这种耻辱感的交叉情况，包括其与心理健康的关系，以提供有针对性干预措施的进一步见解。
