Monthly Archives: March 2023

Purpose: Men who have sex with men (MSM) experience high levels of stigma and discrimination. Previous studies in Malaysia have demonstrated that discrimination toward MSM extends to clinical care settings, leading to MSM’s disengagement from healthcare, thus resulting in poor health outcomes. Minimizing stigma and discrimination against MSM is critical to fostering an inclusive environment for care and optimizing health outcomes. The purpose of this study was to explore the sociodemographic and stigma-related correlates of physicians’ intention to discriminate against MSM.

Methods: Physicians (N=568) from two university-affiliated hospitals in Kuala Lumpur, Malaysia, completed an online cross-sectional survey. Measures included sociodemographic characteristics, clinical background, intention to discriminate against MSM, and several stigma-related constructs. Bivariate and multivariate linear regressions were used to evaluate independent correlates of discrimination intent against MSM.

Results: On average, physicians disagreed that they intended to discriminate against MSM (M=1.9, SD=0.7), but 70.6% of physicians expressed some intention to discriminate. The multivariate model demonstrated that physicians who intended to discriminate against MSM expressed greater prejudice (B=0.27, p<0.01), had more internalized shame associated with treating MSM (B=0.25, p<0.01), and fear about MSM (B=0.35, p<0.01).

Conclusions: Stigma-related constructs including prejudice, internalized shame, and fear were positively related to physicians’ intention to discriminate against MSM. Physicians who had less favorable feelings toward people living with HIV also reported more discrimination intent toward MSM. Therefore, implementing interventions to reduce physicians’ stigma toward MSM and unfavorable feelings toward people living with HIV may promote equitable and stigma-free access to healthcare.

Background: TB preventative therapy (TPT) is crucial for reducing the burden of TB in endemic settings. We assessed stigma associated with TPT and the social groups from whom stigma was anticipated.

Methods: We conducted an anonymous cross-sectional survey of community-dwelling adults in rural South Africa. Descriptive statistics, exploratory factor analysis, χ2 tests, Kruskal–Wallis tests, and Poisson regression were used to identify factors associated with TPT stigma.

Results: The mean age of the 104 participants was 35 years, 65% were female, and 26% had completed secondary school. The vast majority perceived stigma associated with TPT (71%; mean score 1.7, SD ± 1.4). Factor analysis identified a two-factor solution that explained 61.9% of the variance. Being single (P < 0.001), previously screened for TB (P = 0.04), worried about being infected by TB (P = 0.006), and interested in taking TPT (P = 0.01) were associated with higher perceived stigma scores. TPT stigma was perceived among 8%, 16%, and 66% of their family, friends, and other community members, respectively.

Conclusion: The prevalence of TPT-related stigma in a rural South African community was high. Community members anticipated less stigma from family members compared to other social groups. Global expansion and implementation of TPT will require novel interventions, such as engaging patients´ families to support uptake and promote adherence.