title: Tuberculosis and AIDS stigma among patients who delay seeking care for tuberculosis symptoms.
abstract: BACKGROUND
  Delay in presentation to a health facility is an important concern for tuberculosis (TB) control. The effect of stigma on delay in seeking care for TB symptoms is not well studied, especially in the context of the human immunodeficiency virus (HIV) co-epidemic.
  
  
  OBJECTIVE
  To estimate the association of TB and acquired immune-deficiency syndrome (AIDS) stigma on delay in seeking care for TB symptoms.
  
  
  METHODS
  For 480 newly diagnosed patients with TB, time from first TB symptom to the first visit to a qualified provider was calculated. Stigma scales were administered to each patient to obtain a stigma score.
  
  
  RESULTS
  Among men, those with higher TB stigma had a small increase in delay times, while women had a small decrease in delay. Among patients presenting with hemoptysis, higher TB stigma was associated with a small increase in delay, while among patients presenting with fever or extra-pulmonary symptoms only, higher TB and AIDS stigma resulted in shorter delay times.
  
  
  CONCLUSIONS
  In a population with a relatively short median delay (26 days), the impact of TB and AIDS stigma translates into a minimal change in delay time. This suggests that stigma does not have a clinically relevant effect on TB patient delay in southern Thailand.
authors.affiliation: Tuberculosis Centre 12, Yala, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Pungrassami
authors.forename: A M
authors.initials: AM
authors.lastname: Kipp
authors.forename: P W
authors.initials: PW
authors.lastname: Stewart
authors.forename: V
authors.initials: V
authors.lastname: Chongsuvivatwong
authors.forename: R P
authors.initials: RP
authors.lastname: Strauss
authors.forename: A
authors.initials: A
authors.lastname: Van Rie
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D057210:Delayed Diagnosis / Q000523:psychology*; D005260:Female; D006469:Hemoptysis / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D012737:Sex Factors; D013240:Stereotyping; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis* / Q000523:psychology; D055815:Young Adult