Fear, distress, and perceived risk shape stigma toward Ebola survivors: a prospective longitudinal study

Abstract Background During the 2014–15 Ebola Virus Disease (EVD) epidemic, thousands of people in Sierra Leone were infected with the devastating virus and survived. Years after the epidemic was declared over, stigma toward EVD survivors and others affected by the virus is still a major concern, but...

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Autores principales:	Cara M. Antonaccio, Phuong Pham, Patrick Vinck, Katharine Collet, Robert T. Brennan, Theresa S. Betancourt
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Infectious disease Stigma Ebola virus Epidemic Sierra Leone Public health Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/a52d0900206442659bc81613a0080049
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spelling	oai:doaj.org-article:a52d0900206442659bc81613a00800492021-11-14T12:14:23ZFear, distress, and perceived risk shape stigma toward Ebola survivors: a prospective longitudinal study10.1186/s12889-021-12146-01471-2458https://doaj.org/article/a52d0900206442659bc81613a00800492021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12146-0https://doaj.org/toc/1471-2458Abstract Background During the 2014–15 Ebola Virus Disease (EVD) epidemic, thousands of people in Sierra Leone were infected with the devastating virus and survived. Years after the epidemic was declared over, stigma toward EVD survivors and others affected by the virus is still a major concern, but little is known about the factors that influence stigma toward survivors. This study examines how key personal and ecological factors predicted EVD-related stigma at the height of the 2014–2015 epidemic in Sierra Leone, and the personal and ecological factors that shaped changes in stigma over time. Methods Using three waves of survey data from a representative sample in the Western Urban and Western Rural districts of Sierra Leone, this study examines factors associated with self-reported personal stigma toward Ebola survivors (11 items, α = 0.77) among 1008 adults (74.6% retention rate) from 63 census enumeration areas of the Western Rural and Western Urban districts of Sierra Leone. Participants were randomly sampled at the height of the EVD epidemic and followed up as the epidemic was waning and once the epidemic had been declared over by the WHO. Three-level mixed effects models were fit using Stata 16 SE to examine cross-sectional associations as well as predictors of longitudinal changes in stigma toward EVD survivors. Results At the height of the EVD epidemic, female sex, household wealth, post-traumatic stress, EVD-related fear and perceived infection risk are a few of the factors which predicted higher levels of stigma toward survivors. On average, stigma toward EVD survivors decreased significantly as the epidemic declined in Sierra Leone, but female sex, EVD fear, and risk perceptions predicted a slower rate of change. Conclusion This study identified key individual and psychosocial characteristics which may predict higher levels of stigma toward infectious disease survivors. Future studies should pursue a better understanding of how personal characteristics and perceptions, including psychosocial distress, fear, and perceived infection risk serve as pathways for stigma in communities affected by infectious disease.Cara M. AntonaccioPhuong PhamPatrick VinckKatharine ColletRobert T. BrennanTheresa S. BetancourtBMCarticleInfectious diseaseStigmaEbola virusEpidemicSierra LeonePublic healthPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Infectious disease Stigma Ebola virus Epidemic Sierra Leone Public health Public aspects of medicine RA1-1270
spellingShingle	Infectious disease Stigma Ebola virus Epidemic Sierra Leone Public health Public aspects of medicine RA1-1270 Cara M. Antonaccio Phuong Pham Patrick Vinck Katharine Collet Robert T. Brennan Theresa S. Betancourt Fear, distress, and perceived risk shape stigma toward Ebola survivors: a prospective longitudinal study
description	Abstract Background During the 2014–15 Ebola Virus Disease (EVD) epidemic, thousands of people in Sierra Leone were infected with the devastating virus and survived. Years after the epidemic was declared over, stigma toward EVD survivors and others affected by the virus is still a major concern, but little is known about the factors that influence stigma toward survivors. This study examines how key personal and ecological factors predicted EVD-related stigma at the height of the 2014–2015 epidemic in Sierra Leone, and the personal and ecological factors that shaped changes in stigma over time. Methods Using three waves of survey data from a representative sample in the Western Urban and Western Rural districts of Sierra Leone, this study examines factors associated with self-reported personal stigma toward Ebola survivors (11 items, α = 0.77) among 1008 adults (74.6% retention rate) from 63 census enumeration areas of the Western Rural and Western Urban districts of Sierra Leone. Participants were randomly sampled at the height of the EVD epidemic and followed up as the epidemic was waning and once the epidemic had been declared over by the WHO. Three-level mixed effects models were fit using Stata 16 SE to examine cross-sectional associations as well as predictors of longitudinal changes in stigma toward EVD survivors. Results At the height of the EVD epidemic, female sex, household wealth, post-traumatic stress, EVD-related fear and perceived infection risk are a few of the factors which predicted higher levels of stigma toward survivors. On average, stigma toward EVD survivors decreased significantly as the epidemic declined in Sierra Leone, but female sex, EVD fear, and risk perceptions predicted a slower rate of change. Conclusion This study identified key individual and psychosocial characteristics which may predict higher levels of stigma toward infectious disease survivors. Future studies should pursue a better understanding of how personal characteristics and perceptions, including psychosocial distress, fear, and perceived infection risk serve as pathways for stigma in communities affected by infectious disease.
format	article
author	Cara M. Antonaccio Phuong Pham Patrick Vinck Katharine Collet Robert T. Brennan Theresa S. Betancourt
author_facet	Cara M. Antonaccio Phuong Pham Patrick Vinck Katharine Collet Robert T. Brennan Theresa S. Betancourt
author_sort	Cara M. Antonaccio
title	Fear, distress, and perceived risk shape stigma toward Ebola survivors: a prospective longitudinal study
title_short	Fear, distress, and perceived risk shape stigma toward Ebola survivors: a prospective longitudinal study
title_full	Fear, distress, and perceived risk shape stigma toward Ebola survivors: a prospective longitudinal study
title_fullStr	Fear, distress, and perceived risk shape stigma toward Ebola survivors: a prospective longitudinal study
title_full_unstemmed	Fear, distress, and perceived risk shape stigma toward Ebola survivors: a prospective longitudinal study
title_sort	fear, distress, and perceived risk shape stigma toward ebola survivors: a prospective longitudinal study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/a52d0900206442659bc81613a0080049
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Fear, distress, and perceived risk shape stigma toward Ebola survivors: a prospective longitudinal study

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