Arthur Labatt Family School of Nursing, Western University, London, ON, Canada.
Viral Hepatitis Care Network (VIRCAN) Study Group, Toronto Centre for Liver Disease, Toronto, ON, Canada.
BMC Public Health. 2024 Sep 28;24(1):2660. doi: 10.1186/s12889-024-20131-6.
Stigma is a complex social phenomenon that leads to marginalization and influences the course of illness. In the context of hepatitis C virus (HCV), stigma is a well-documented barrier to accessing care, treatment, and cure. In recent years, HCV rates among women have increased, resulting in an urgent need to address stigma and its harmful effects. The purpose of this concept analysis was to investigate stigma in the context of women living with HCV using Rodgers' evolutionary method.
PubMed, CINAHL, Scopus, Medline, PsycINFO, and Nursing and Allied Health were used to identify articles describing HCV stigma among women. Articles from peer-reviewed journals and geographic locations, published between 2002-2023, were included in the analysis. As specified in Rodgers' evolutionary method, articles were analyzed with a focus on the concept's context, surrogate and related terms, antecedents, attributes, examples, and consequences.
Following screening, 33 articles were selected for inclusion in the analysis. Discrimination and marginalization were identified as surrogate and related terms to stigma; and antecedents of stigma were identified as limited knowledge, fear of diagnosis, and disclosure. Prevalent attributes of stigma in the literature were described as feelings of decreased self-worth, negative stereotyping, and fear of transmission. Importantly, HCV stigma among women is unique in comparison to other forms of infectious disease-related stigma, primarily due its impact on women's identity as mothers and caregivers. Stigmatization of women living with HCV resulted in negative consequences to personal relationships and healthcare access due to decreased health-seeking behaviours. Although access to HCV treatment has changed considerably over time, a temporal analysis could not be completed due to the limited number of articles.
Stigma in the context of women living with HCV has its own unique antecedents, attributes, and consequences. This enhanced understanding of stigma among women living with HCV has the potential to inform improved and more effective approaches to care, which will be required to reach HCV elimination. Furthermore, this analysis identifies stigma layering and stigma in the direct-acting antiviral treatment era as areas for more in-depth future inquiry.
污名是一种复杂的社会现象，会导致边缘化，并影响疾病进程。在丙型肝炎病毒（HCV）的背景下，污名是获得护理、治疗和治愈的一个有据可查的障碍。近年来，女性的 HCV 感染率有所上升，因此迫切需要解决污名及其有害影响。本概念分析的目的是使用 Rodgers 的进化方法，研究感染 HCV 的女性的污名问题。
使用 PubMed、CINAHL、Scopus、Medline、PsycINFO 和护理与相关健康专业数据库，检索描述女性 HCV 污名的文章。分析纳入了发表于 2002-2023 年期间、来自同行评议期刊且地理位置明确的文章。按照 Rodgers 进化方法的要求，重点分析了概念的背景、替代和相关术语、前提、属性、实例和后果。
经过筛选，有 33 篇文章被纳入分析。歧视和边缘化被确定为污名的替代和相关术语；污名的前提被确定为知识有限、害怕诊断和披露。文献中污名的普遍属性描述为自我价值感降低、负面刻板印象和对传播的恐惧。重要的是，与其他形式的传染病相关污名相比，女性 HCV 污名具有独特性，主要是因为它对女性作为母亲和照顾者的身份认同的影响。感染 HCV 的女性受到污名化，导致个人关系和医疗保健机会受到负面影响，因为她们减少了寻求健康的行为。尽管 HCV 治疗的可及性随着时间的推移发生了很大变化，但由于文章数量有限，无法进行时间分析。
感染 HCV 的女性的污名有其独特的前提、属性和后果。对感染 HCV 的女性污名的这种更深入的理解，有可能为改善和更有效的护理方法提供信息，这将是实现 HCV 消除所必需的。此外，本分析确定了污名分层和直接作用抗病毒治疗时代的污名是未来更深入探究的领域。
