Tuberculosis (TB) stigma arises from fear of infection, the belief that it causes financial ruin and eventually leads to death, and misunderstandings of how TB spreads. In India, that fear is perpetuated by prevalent socio-behavioral norms. All of this results in vicious cycles of isolation, social exclusion, poverty, low self-esteem, and compromised efficacy. It drives persons with TB to hide the disease, programmatically impacting treatment success and TB notification. Ultimately, stigma is a barrier to effective TB management.
Abt employed a multi-faceted methodology to understand TB stigma in India. We used desk research, health-related anti-stigma media campaigns, focus group discussions with affected and vulnerable people, in-depth interviews with healthcare providers, technical discussions, and experiential insights. Our findings—synthesized using the socio-ecological model of influence—showed how stigma influences people connected to persons with TB, including close family and friends whose behaviors adversely impact those affected.