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 journalReview articlepeer-review


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 (US)
Article number17
JournalBMC medicine
Issue number1
StatePublished - Feb 15 2019


  • Depression
  • Epilepsy
  • HIV
  • Low- and middle-income countries
  • Scoping review
  • Stigma
  • Substance use
  • Tuberculosis

ASJC Scopus subject areas

  • Medicine(all)

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