A scoping review of health-related stigma outcomes for high-burden diseases in low- and middle-income countries

Jeremy C Kane, Melissa A Elafros, Sarah M Murray, Ellen M H Mitchell, Jura L Augustinavicius, Sara Causevic, Stefan D Baral

Research output: Contribution to journalA1: Web of Science-articlepeer-review

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BACKGROUND: Stigma is associated with health conditions that drive disease burden in low- and middle-income countries (LMICs), including HIV, tuberculosis, mental health problems, epilepsy, and substance use disorders. However, the literature discussing the relationship between stigma and health outcomes is largely fragmented within disease-specific siloes, thus limiting the identification of common moderators or mechanisms through which stigma potentiates adverse health outcomes as well as the development of broadly relevant stigma mitigation interventions.

METHODS: We conducted a scoping review to provide a critical overview of the breadth of research on stigma for each of the five aforementioned conditions in LMICs, including their methodological strengths and limitations.

RESULTS: Across the range of diseases and disorders studied, stigma is associated with poor health outcomes, including help- and treatment-seeking behaviors. Common methodological limitations include a lack of prospective studies, non-representative samples resulting in limited generalizability, and a dearth of data on mediators and moderators of the relationship between stigma and health outcomes.

CONCLUSIONS: Implementing effective stigma mitigation interventions at scale necessitates transdisciplinary longitudinal studies that examine how stigma potentiates the risk for adverse outcomes for high-burden health conditions in community-based samples in LMICs.

Original languageEnglish
Article number17
JournalBMC Medicine
Issue number1
Number of pages40
Publication statusPublished - 2019


  • Developing Countries
  • Epilepsy
  • HIV Infections
  • Humans
  • Male
  • Mental Disorders
  • Social Stigma
  • Substance-Related Disorders
  • Tuberculosis


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