title: Dual Perspectives On Stigma: Reports of Experienced and Enacted Stigma by Those Affected and Unaffected by Podoconiosis.
abstract: Background:Disease-related stigma is a public health concern steadily gaining global attention. Evidence consistently shows that an individual's attribution of disease cause can prompt or justify interpersonal stigma. However, few studies have explored causal beliefs about inherited disease and their influence on stigmatising behaviours in low and middle income countries.Design and methods:The study was conducted in 2013, in six communities in Wolaita zone, Southern Ethiopia. A total of 1800 respondents took part in the study, 600 were affected by an inherited disease and 1200 were unaffected neighbours. Two versions of the interviewer-administered survey were created, with measures assessed in parallel onexperiencedstigma for the affected andenactedstigma for unaffected respondents.Results:Mean levels of enacted stigma reported by unaffected respondents were slightly lower (2.0, SD=0.7) than experienced stigma reported by affected respondents [2.2 (standard deviation=1.1)]. Beliefs that podoconiosis was hereditary were significantly and positively associated with levels of enacted stigma reported by unaffected respondents and experienced stigma reported by affected respondents (P<0.001). There was no association of reported levels of stigma experienced by affected respondents with levels of enacted stigma reported by the neighbouring unaffected respondents. Males consistently reported significantly lower levels of experienced and enacted stigma than females, P<0.0001.Conclusions:If stigma reduction interventions are to be successful, culturally tailored, gender inclusive and innovative health education programs are required, directed at the general community as well as individuals affected by inherited diseases.
authors.affiliation: College of Social Sciences, Addis Ababa University , Addis Ababa, Ethiopia.
authors.forename: Desta
authors.initials: D
authors.lastname: Ayode
authors.affiliation: Department of Sociology, Wolaita Sodo University , Sodo, Ethiopia.
authors.forename: Abebayehu
authors.initials: A
authors.lastname: Tora
authors.affiliation: People Designs Inc. , Durham, NC, USA.
authors.forename: David
authors.initials: D
authors.lastname: Farrell
authors.affiliation: College of Social Sciences, Addis Ababa University , Addis Ababa, Ethiopia.
authors.forename: Getnet
authors.initials: G
authors.lastname: Tadele
authors.affiliation: Brighton and Sussex Medical School , Falmer, Brighton, UK.
authors.forename: Gail
authors.initials: G
authors.lastname: Davey
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University , Atlanta, CA, USA.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: McBride
keywords: Enacted stigma; Experienced stigma; Podoconiosis