Dissertation/Thesis Abstract

Tuberculosis and stigma: Impacts on health -seeking behaviors and access in Ciudad Juárez, México and El Paso, Texas
by Moya, Eva Margarita, Ph.D., The University of Texas at El Paso, 2010, 332; 3409176
Abstract (Summary)

This exploratory research is a study of tuberculosis (TB) and health-related stigma which examines the experiences and perspectives on the disease from the vantage point of the Persons Affected by Tuberculosis (PATB). Research on the causes and sustainability of stigma will be useful to guide health and social interventions that reduce its effects. Also of importance is research that focuses on the behavioral and psychological as well as in the social context and dimensions of TB-related stigma. The personal experience of tuberculosis illustrates that an infectious disease entails much more than treatment involving medications, microbes and risk categories. Stigma associated with TB has been identified as a major barrier to health care access and to quality of life in TB management. This study of TB and stigma is the result of a triangulation of data from three different and complementary studies using corresponding methods of data collection and is organized into three distinct sections: (1) In-depth interviews with Persons Affected by TB and under treatment using a semi-structured interview guide, (2) In-depth interviews with TB Photovoice participants, and (3) Measuring TB-related stigma through the validation of the TB and HIV/AIDS stigma subscales, originally developed by Van Rie et al., (2008).

The findings of this study may provide the basis for the future development of individual and structural stigma reduction interventions with Mexican-origin groups in order to ensure that persons affected by tuberculosis receive crucial preventive, diagnostic and treatment services that are free of stigma and discrimination.

Study participants reported traditional beliefs and myths about tuberculosis TB symptoms. The participants presented issues of stigma associated with tuberculosis and HIV/AIDS. They also reported on reliable and popular sources of health information. Participants presented their views regarding the barriers to TB care that include individual and social obstacles as identified in the “Tuberculosis and Stigma Study.” Finally, the scales used to measure the phenomenon of stigma related to TB and HIV/AIDS with Mexican-origin groups demonstrated strong psychometric properties. Factor analysis to identify the items of the scale that loaded best were performed and the internal consistency by Cronbach’s Alphas were very good to excellent.

The dissertation concludes that tuberculosis is in many respects a social illness and that socioeconomic differentials and inequalities are strongly associated with its burden. Study findings have implications for: (1) informing health services and decision makers about how persons of Mexican-origin affected with TB in the United States-México border interpret their illness and stigma, (2) research on health related stigma and interventions, and (3) expanding and informing health-related theory on tuberculosis stigma and individual and structural stigma reduction interventions.

Indexing (document details)
Advisor: Lusk, Mark W.
Commitee: Balcazar, Hector, Biswas, Amitava, Shedlin, Michele G.
School: The University of Texas at El Paso
Department: Interdisciplinary Health Sciences
School Location: United States -- Texas
Source: DAI-A 71/07, Dissertation Abstracts International
Subjects: Social research, Public health, Health education
Keywords: Access, Ciudad Juarez, El Paso, HIV/AIDS, Health-seeking, Health-seeking behaviors, Mexico, Stigma, Texas, Tuberculosis, United States-Mexico
Publication Number: 3409176
ISBN: 978-1-124-06426-0
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