Anticipated stigma, stereotypes, and COVID-19 testing.

Abstract

Testing for COVID-19 is important for identifying, tracing, and treating COVID-19 cases as well as informing policy decisions. Evidence from other disease epidemics suggests that anticipated stigma and stereotypes are barriers to testing for disease. Anticipated stigma may undermine testing due to labeling avoidance (i.e., efforts to avoid receiving the label of a stigmatized status) and stereotypes may undermine testing by reducing perceived vulnerability to disease. Given the importance of scaling up COVID-19 testing, the current study explored the potential roles of anticipated stigma and stereotypes in COVID-19 testing. A cross-sectional, online survey was conducted with 845 United States adults in April 2020. Measures were adapted from previous studies of stigma associated with infectious diseases, and participants were asked about the likelihood that they would seek a COVID-19 test if one were to be ordered by their doctor. Analyses demonstrated that participants who anticipated greater COVID-19 stigma and endorsed COVID-19 stereotypes to a greater degree reported that they would be less likely to seek a COVID-19 test. Notably, endorsement of anticipated stigma and stereotypes was low, and knowledge and fear were stronger predictors of testing than stigma. Nonetheless, results provide preliminary evidence that anticipated stigma and stereotypes may represent barriers to testing in the context of COVID-19, similar to other diseases. As COVID-19 tests become more widely available, efforts may be needed to address COVID-19 stigma alongside other barriers such as access and knowledge to maximize testing efforts.

Pandemic Birthing: Childbirth Satisfaction, Perceived Health Care Bias, and Postpartum Health During the COVID-19 Pandemic

“…Further, women who were SARS-CoV-2 positive, and therefore more likely to experience stress and isolation, reported poorer birth satisfaction and more incidents of health care discrimination. This finding supports the assertion that SARS-CoV-2 testing measures must be implemented with concern for potential stigma (Earnshaw et al, 2020 ).…”

Medical Mistrust and Stigma Associated with COVID-19 Among People Living with HIV in South Africa

“…Since early in the COVID-19 pandemic, stigmatizing beliefs and behaviors towards people of Asian descent, health workers, COVID-19 patients, and marginalized populations have been reported, and have even culminated in violent action [12][13][14][15][16][17][18]. Stereotypes (beliefs about characteristics of a stigmatized group and its members [19]) and anticipated stigma (the expectation of future discrimination [19]) related to COVID-19 have been found to impact willingness to undergo COVID-19 testing [20]. Stigma is increasingly understood as intersectional [21], influenced by drivers such as misinformation, historical trauma, or systemic racism that can fuel stigma related to multiple health conditions, with the intersection of multiple stigmas in turn leading to social, economic, and health-related outcomes [22].…”

Analyzing Socioeconomic Factors and Health Disparity of COVID-19 Spatiotemporal Spread Patterns at Neighborhood Levels in San Diego County

“…Stigma of having COVID-19 is a major source of distress and a key challenge that must be overcome to implement an effective public health response. Stigmatization can negatively impact motivation and behaviors of individuals affected by COVID-19 and may result in hiding or underreporting symptoms, failure to report important medical history (Peprah and Gyasi 2020) or seek a COVID-19 test (Earnshaw et al 2020). Immigrants with limited access to healthcare and fear of potential legal repercussions have higher risk of becoming infected and developing severe COVID-19 symptoms (Clark et al 2020).…”

“…Media can be an effective method to reduce stigma. Providing up-to-date knowledge and debunking myths and misperceptions related to COVID-19 via use of media interventions can reduce stigma as well as promote health seeking behaviors such as COVID-19 testing in the public (Duan, Bu, and Chen 2020; Earnshaw et al 2020). Such messages need to be provided in a culturally appropriate manner, with consideration to the languages and characteristics of stigmatized groups or communities (Peprah and Gyasi 2020).…”