Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA.
Battelle, Columbus, OH, 43201, USA.
BMC Public Health. 2023 Oct 27;23(1):2110. doi: 10.1186/s12889-023-17042-3.
Growing evidence suggests that individuals with COVID-19 face stigmatization, which is associated with poor health outcomes and behaviors. However, very few population-based studies have examined risk factors for experiencing COVID-19 stigma. This study examined prevalence and predictors of perceived COVID-19 stigma using a population-based probability sample of adults with COVID-19.
We included adults with polymerase chain reaction-confirmed SARS-CoV-2 in Michigan between January 1, 2020 and July 31, 2021. Perceived COVID-19 stigma was considered present if a respondent answered affirmatively to any of the following items due to people thinking they might have COVID-19: "you were treated badly," "people acted as if they were scared of you," and "you were threatened or harassed." We conducted modified Poisson regression with robust standard errors to estimate associations between perceived COVID-19 stigma and potential predictors, including sex, age, race and ethnicity, household income, education, employment, smoking status, body mass index, preexisting diagnosed physical or mental comorbidities, and COVID-19 illness severity.
Perceived COVID-19 stigma was commonly reported among our respondents (38.8%, n = 2,759). Compared to those over 65 years, respondents who were 18 - 34 (adjusted prevalence ratio (aPR): 1.41, 95% confidence intervals (CI): 1.12 - 1.77) and 35 - 44 years old (aPR: 1.66, 95% CI: 1.31 - 2.09) reported higher perceived stigma. Female respondents had 1.23 times higher prevalence of perceived COVID-19 stigma (95% CI: 1.10 - 1.37) than male respondents and non-Hispanic Black respondents had 1.22 times higher prevalence of perceived COVID-19 stigma (95% CI: 1.04 - 1.44) than non-Hispanic White respondents. Moreover, respondents with pre-existing diagnosed psychological or psychiatric comorbidities were more likely to report perceived COVID-19 stigma (aPR: 1.29, 95% CI: 1.13 - 1.48) compared to those without diagnosed comorbidities. Respondents with very severe COVID-19 symptoms were also more likely to report perceived COVID-19 stigma (aPR: 1.47, 95% CI: 1.23 - 1.75) than those with asymptomatic or mild symptoms.
We found that populations who are marginalized in United States, such as females, non-Hispanic Black adults, or individuals with chronic conditions, are more likely to report perceived COVID-19 stigma. Continuing to monitor COVID-19 stigma, especially in vulnerable populations, may provide useful insights for anti-stigma campaigns and future pandemics.
越来越多的证据表明，新冠病毒感染者面临污名化，这与较差的健康结果和行为有关。然而，很少有基于人群的研究探讨了新冠病毒污名化的风险因素。本研究使用基于人群的概率样本，对患有新冠病毒的成年人进行了调查，以评估感知到的新冠病毒污名的流行情况和预测因素。
我们纳入了 2020 年 1 月 1 日至 2021 年 7 月 31 日期间在密歇根州接受聚合酶链反应确诊的 SARS-CoV-2 成人患者。如果受访者因他人认为他们可能患有新冠病毒而对以下任何一项做出肯定回答，则认为存在感知到的新冠病毒污名：“你受到了恶劣对待”、“人们对你的行为表现得好像他们很害怕你”和“你受到了威胁或骚扰”。我们使用修正泊松回归模型，采用稳健标准差来估计感知到的新冠病毒污名与潜在预测因素之间的关联，包括性别、年龄、种族和民族、家庭收入、教育程度、就业状况、吸烟状况、体重指数、预先诊断的身体或精神合并症以及新冠病毒疾病严重程度。
我们的受访者中普遍存在感知到的新冠病毒污名（38.8%，n=2759）。与 65 岁以上的受访者相比，18-34 岁（调整后的患病率比（aPR）：1.41，95%置信区间（CI）：1.12-1.77）和 35-44 岁（aPR：1.66，95%CI：1.31-2.09）的受访者报告的感知污名更高。女性受访者的感知新冠病毒污名患病率比男性受访者高 1.23 倍（95%CI：1.10-1.37），而非西班牙裔黑人受访者的感知新冠病毒污名患病率比非西班牙裔白人受访者高 1.22 倍（95%CI：1.04-1.44）。此外，患有预先诊断的心理或精神合并症的受访者更有可能报告感知到的新冠病毒污名（aPR：1.29，95%CI：1.13-1.48），而非没有诊断出合并症的受访者。新冠病毒症状非常严重的受访者也更有可能报告感知到的新冠病毒污名（aPR：1.47，95%CI：1.23-1.75），而非无症状或轻症的受访者。
我们发现，在美国处于边缘地位的人群，如女性、非西班牙裔黑人成年人或患有慢性疾病的人，更有可能报告感知到的新冠病毒污名。继续监测新冠病毒污名，特别是在弱势群体中，可能为反污名运动和未来的大流行提供有用的见解。
