title: Perceptions of genetic discrimination among people at risk for Huntington's disease: a cross sectional survey.
abstract: OBJECTIVE
  To assess the nature and prevalence of genetic discrimination experienced by people at risk for Huntington's disease who had undergone genetic testing or remained untested.
  
  
  METHODS
  Cross sectional, self reported survey.
  
  
  METHODS
  Seven genetics and movement disorders clinics servicing rural and urban communities in Canada.
  
  
  METHODS
  233 genetically tested and untested asymptomatic people at risk for Huntington's disease (response rate 80%): 167 underwent testing (83 had the Huntington's disease mutation, 84 did not) and 66 chose not to be tested.
  
  
  METHODS
  Self reported experiences of genetic discrimination and related psychological distress based on family history or genetic test results.
  
  
  RESULTS
  Discrimination was reported by 93 respondents (39.9%). Reported experiences occurred most often in insurance (29.2%), family (15.5%), and social (12.4%) settings. There were few reports of discrimination in employment (6.9%), health care (8.6%), or public sector settings (3.9%). Although respondents who were aware that they carried the Huntington's disease mutation reported the highest levels of discrimination, participation in genetic testing was not associated with increased levels of genetic discrimination. Family history of Huntington's disease, rather than the result of genetic testing, was the main reason given for experiences of genetic discrimination. Psychological distress was associated with genetic discrimination (P<0.001).
  
  
  CONCLUSIONS
  Genetic discrimination was commonly reported by people at risk for Huntington's disease and was a source of psychological distress. Family history, and not genetic testing, was the major reason for genetic discrimination.
authors.affiliation: Department of Medical Genetics, University of British Columbia, Vancouver, BC, V5Z 4H4, Canada.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Bombard
authors.forename: Gerry
authors.initials: G
authors.lastname: Veenstra
authors.forename: Jan M
authors.initials: JM
authors.lastname: Friedman
authors.forename: Susan
authors.initials: S
authors.lastname: Creighton
authors.forename: Lauren
authors.initials: L
authors.lastname: Currie
authors.forename: Jane S
authors.initials: JS
authors.lastname: Paulsen
authors.forename: Joan L
authors.initials: JL
authors.lastname: Bottorff
authors.forename: Michael R
authors.initials: MR
authors.lastname: Hayden
mesh_terms: D001294:Attitude to Health; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D005817:Genetic Counseling; D005820:Genetic Testing / Q000523:psychology*; D006801:Humans; D006816:Huntington Disease / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D010465:Perception; D011287:Prejudice; D012307:Risk Factors; D012423:Rural Health; D013315:Stress, Psychological / Q000209:etiology; D014504:Urban Health