title: Survey of hepatitis B knowledge and stigma among chronically infected patients and uninfected persons in Beijing, China.
abstract: Hepatitis B virus (HBV) infection carries substantial stigma in China. We surveyed HBV knowledge and stigma among chronic hepatitis B (CHB) patients and persons without HBV infection in Beijing, China.
  
  
  
  Four hundred and thirty five CHB patients and 801 controls at Peking University People's Hospital were surveyed.
  
  
  
  Chronic hepatitis B patients were older (mean 46 vs. 39 years) and more often men (71 vs. 48%) than controls. Mean knowledge score was 11.9/15 for CHB and 9.3/15 for control patients (P < 0.001). Average stigma score was 22.1/39 for CHB and 19.2/30 for control patients. Controls expressed discomfort with close contact (45%) or sharing meals with CHB patients (39%) and believed CHB patients should not be allowed to work in restaurants (58%) or childcare (44%). Chronic hepatitis B patients felt that they were undesirable as spouses (33 vs. 17%) and brought trouble to their families (58 vs. 34%) more often than controls. Despite legal prohibitions, 40% of CHB patients were required to undergo pre-employment HBV testing, and 29% of these individuals thought that they lost job opportunities because of their disease status. 16% of CHB patients regretted disclosing their HBV status and disclosure was inversely associated with stigma. Higher stigma was associated with older age, lower education and lower knowledge score among controls; and with lower education, younger age, having undergone pre-employment HBV testing and regret disclosing their HBV status among CHB patients.
  
  
  
  Despite high prevalence of CHB in China, our study shows knowledge is limited and there is significant societal and internalized stigma associated with HBV infection.
authors.affiliation: University of Michigan Medical School, Ann Arbor, MI, USA.
authors.forename: Jiaxin
authors.initials: J
authors.lastname: Huang
authors.affiliation: University of Michigan Medical School, Ann Arbor, MI, USA.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Guan
authors.affiliation: University of Michigan Medical School, Ann Arbor, MI, USA.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Balch
authors.affiliation: Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Wu
authors.affiliation: Peking University Hepatology Institute, Peking University People's Hospital, Beijing, China.
authors.forename: Huiying
authors.initials: H
authors.lastname: Rao
authors.affiliation: The Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Andy
authors.initials: A
authors.lastname: Lin
authors.affiliation: Peking University Hepatology Institute, Peking University People's Hospital, Beijing, China.
authors.forename: Lai
authors.initials: L
authors.lastname: Wei
authors.affiliation: Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA. aslok@umich.edu.
authors.forename: Anna S
authors.initials: AS
authors.lastname: Lok
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006515:Hepatitis B virus; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D063508:Social Discrimination / Q000706:statistics & numerical data*; D057545:Social Stigma; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: chronic hepatitis B; discrimination; hepatitis B virus; infection; transmission