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TB stigma and its correlates among HIV-positive people who inject drugs in Ukraine

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BACKGROUND: 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.

METHODS: 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.

RESULTS: Lower perceived TB stigma scores were associated with LTBI status (adjusted beta (aβ) –0.2, 95% CI –0.3 to 0.0; P = 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; P = 0.004). Depressive symptoms were common in this sample, although not significantly associated with TB status.

CONCLUSION: 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.
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Keywords: HIV; Ukraine; mental health; perceived stigma; tuberculosis

Document Type: Research Article

Affiliations: 1: 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 2: Ukrainian Institute on Public Health Policy Consultant, Kyiv, Ukraine 3: Ukrainian Institute on Public Health Policy, Kyiv, Ukraine 4: Department of Medicine, Boston Medical Center, Boston, MA 5: Warren Alpert Medical School of Brown University, Providence, RI 6: Internal Medicine, McLaren Flint/Michigan State University, Flint, MI, USA 7: Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia, Bashkir State Medical University, Ufa, Russia, Moscow Institute of Physics and Technology, Moscow, Russia 8: Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, Boston University Center for Implementation & Improvement Sciences, Boston, MA, USA

Publication date: September 1, 2021

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

    The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.

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