COVID-19-related Stigma Among the Affected Individuals: A Cross-Sectional Study From Kerala, India

Abstract

Background: The studies and case reports from various parts of the world are showing discrimination and stigma associated with COVID-19. Stigma can directly worsen the mental health of people and also worsen physical health indirectly. This study is aimed to assess the anticipatory and experienced stigma associated with COVID-19 in affected individuals. Methods: This was a cross-sectional study conducted at Palakkad District in Kerala. Study participants were patients diagnosed with COVID-19. The sampling method was convenience sampling and snowball sampling. COVID-19 Related Stigma Survey Questionnaire was prepared by experts from the field of Psychiatry and Community Medicine. The responses were collected via an online survey and telephonic interview. Results: Among the total participants (N=303) 119 participants (39.3%) wanted to keep the illness a secret. Eighty-one participants (26.7%) had fear of discrimination from others. Eighty-nine participants (29.4%) had experienced stigma related to their COVID-19 infection. Seventy-five (24.8%) participants’ family members had experienced stigma. Few stigma parameters were significantly higher among the younger people. The participants belonging to the below poverty line category and the participants with lesser education showed significantly more worry about rejoining society after the isolation. Below poverty line category also had significantly more worry about discrimination towards their family members. Participants with lower education had significantly more worry about affecting their job due to the illness. Health care workers had significantly high worry regarding others attitudes towards them. Conclusion: There is a high level of stigma associated with COVID-19 in society. Definite measures need to be taken to reduce the stigma related to COVID-19 infection.

Social stigma during COVID-19: A systematic review

“…The most common was social isolation. 16,17,19–21,33–35,37,39,41,42,44,47,48,53,56,57,60,73,76,88 In 16 studies blaming from others was the second most common social stigma reported due to being infected with COVID-19. 22,23,39,40,46,48,51–55,60,62,72,83,89 In 13 studies, participants experienced rejection from the social environment.…”

“…22,23,39,40,46,48,51–55,60,62,72,83,89 In 13 studies, participants experienced rejection from the social environment. 29,33,37,44,46,47,50,56,60,73,76,80,83 Other stigmas experienced by COVID-19 patients included psychological pressure, 62,66–72,75,79,81 verbal violence, 20,50–52,55,56,59,61,77,83 avoidance, 22–24,26,40–42,47,54 labeling, 17,19,21,23,27,29,…”

“…In the present review, the most reported stigma was social isolation. 16,17,19,21,24,33,35–37,39,41–44,47–49,53,56–58,60,73,76,80,88 Furthermore, in 16 studies 22,23,39,40,46,48,51–55,60,62,76,83,89 participants experienced blaming from others. Additionally, participants in 14 studies reported rejection from social environment.…”

“…19,24 In another study conducted in India with 91 participants, 98% of participants reported experiencing self-stigma, rejection, and social isolation. 37 The remaining 17 studies reported a prevalence ranging from 3.1% to 44.56 %, 33,36,39,43,47,48,57,63,67,68,72,74,76,77,79,84,89 the lowest prevalence of 3.1% was associated with social isolation and structural stigma and was found in a study conducted in the USA with 1366 participants.…”

“…Additionally, participants in 14 studies reported rejection from social environment. 26,33,37,44,46,47,49,50,56,60,73,76,80,84 Labeling was reported in nine studies, 17,19,21,24,27,29,35,36,66 and avoidance was also reported in 10 studies. [22][23][24]26,[40][41][42]47,49,54 Denial of service, and violence were reported in two studies, 26,83 disgrace was also claimed in only two studies.…”