title: Tuberculosis Knowledge, Awareness, and Stigma Among African-Americans in Three Southeastern Counties in the USA: a Qualitative Study of Community Perspectives.
abstract: To inform strategies to address the tuberculosis (TB) excess among US-born African-Americans, we sought to understand the TB experience in the most highly affected southeastern communities. We conducted semi-structured interviews and focus groups in three communities with a TB excess-urban (Georgia and Tennessee) and rural (North Carolina). Participants from five groups provided diverse perspectives-African-Americans: patients with TB disease or latent TB infection (LTBI), or at high risk of contracting TB; and local community leaders and TB program staff. Few differences emerged between sites. Many participants demonstrated low levels of knowledge and awareness and held many misconceptions about TB. Patients expressed a preference for verbal communication of medical information. Patients reported fear of stigmatization and shunning, but few experienced discrimination. Patient trust for TB program staff was high, though community leaders often assumed the opposite. The findings will help guide interventions to improve knowledge and awareness regarding TB, including specific attention to the role of public and private health care providers in dispelling persistent misinformation about TB. The insight from these communities will help build the scientific foundation required to effectively eliminate health inequities.
authors.affiliation: RTI International, Durham, NC, USA.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Royce
authors.affiliation: ICAP, Mailman School of Public Health, Columbia University, New York, NY, USA. pwc2@columbia.edu.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Colson
authors.affiliation: RTI International, Durham, NC, USA.|International Partnership for Microbicides, Silver Spring, MD, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Woodsong
authors.affiliation: RTI International, Durham, NC, USA.
authors.forename: Tammeka
authors.initials: T
authors.lastname: Swinson-Evans
authors.affiliation: NCHHSTP/Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Wanda
authors.initials: W
authors.lastname: Walton
authors.affiliation: NCHHSTP/Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Maiuri
authors.affiliation: NCHHSTP/Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA.|NCHHSTP/Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Nickolas
authors.initials: N
authors.lastname: DeLuca
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012424:Rural Population / Q000706:statistics & numerical data; D057545:Social Stigma; D015144:Southeastern United States / Q000453:epidemiology; D014376:Tuberculosis / Q000208:ethnology* / Q000523:psychology*; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
keywords: African-American; Health disparities; Health knowledge, attitudes, and practices (KAP); Qualitative research; Stigma; Tuberculosis