S Michelle Griffin1,2, Francis P Karia3, Armand Zimmerman4, Mary Catherine C Minnig4, Monica Swahn5, Jennifer Makelarski1,6, Blandina T Mmbaga4,7,8,9, João Ricardo Nickenig Vissoci4,2, Catherine A Staton4,2. 1. University of New England, (SMG, JM), Biddeford, Maine. 2. Division of Emergency Medicine, Duke University Medical Center (SMG, JRNV, CS), Durham, North Carolina. 3. Duke University School of Medicine (FPK), Durham, North Carolina. 4. Duke Global Health Institute (SMG, AZ, MCCM, BM, JRNV, CS), Durham, North Carolina. 5. Georgia State University School of Public Health (MS), Atlanta, Georgia. 6. Department of Obstetrics and Gynecology (JM), The University of Chicago, Chicago, Illinois. 7. Kilimanjaro Christian Medical Center (BM), Moshi, Tanzania. 8. Kilimanjaro Clinical Research Institute (BM), Moshi, Tanzania. 9. Kilimanjaro Christian Medical University College (BM), Moshi, Tanzania.
Abstract
BACKGROUND: Each year, alcohol use causes 3.3 million deaths globally and accounts for nearly 30% of injuries treated at Kilimanjaro Christian Medical Center (KCMC) in Moshi, Tanzania. Prior research found significant stigma toward patients reporting alcohol use in general and among healthcare providers for this population. METHODS: This mixed-methods study aimed to identify sex-based perspectives of stigma among injury patients, family members, and local community advisory board (CAB) members. Injury patients from the emergency room at KCMC were asked to complete surveys capturing consumption of alcohol, perceived stigma, and consequences of drinking. Patients who completed the survey, their family members, and members of a CAB were also recruited to take part in focus groups led by a trained bilingual research nurse. Data were analyzed using multiple linear regression and Wilcoxon rank sum tests with alpha level set at 0.05. RESULTS: Results showed that sex was a significant predictor of perceived discrimination (p = 0.037, Standard Error (SE) = 1.71 (0.81)) but not for perceived devaluation (p = 0.667, SE = -0.38 (0.89)). Focus groups revealed there were global negative perceptions of the amount of alcohol consumed as well as negative perceptions toward disclosure of alcohol use to healthcare providers. Sex differences in stigma emerged when participants were specifically asked about women and their alcohol consumption. CONCLUSIONS: The findings of this study suggest there is an underlying sex difference, further stigmatizing women for alcohol use among the injury patient population at KCMC. Tanzanian women suffer from unequal access to health care, and the stigmatization of alcohol use likely increases this disparity.
BACKGROUND: Each year, alcohol use causes 3.3 million deaths globally and accounts for nearly 30% of injuries treated at Kilimanjaro Christian Medical Center (KCMC) in Moshi, Tanzania. Prior research found significant stigma toward patients reporting alcohol use in general and among healthcare providers for this population. METHODS: This mixed-methods study aimed to identify sex-based perspectives of stigma among injurypatients, family members, and local community advisory board (CAB) members. Injurypatients from the emergency room at KCMC were asked to complete surveys capturing consumption of alcohol, perceived stigma, and consequences of drinking. Patients who completed the survey, their family members, and members of a CAB were also recruited to take part in focus groups led by a trained bilingual research nurse. Data were analyzed using multiple linear regression and Wilcoxon rank sum tests with alpha level set at 0.05. RESULTS: Results showed that sex was a significant predictor of perceived discrimination (p = 0.037, Standard Error (SE) = 1.71 (0.81)) but not for perceived devaluation (p = 0.667, SE = -0.38 (0.89)). Focus groups revealed there were global negative perceptions of the amount of alcohol consumed as well as negative perceptions toward disclosure of alcohol use to healthcare providers. Sex differences in stigma emerged when participants were specifically asked about women and their alcohol consumption. CONCLUSIONS: The findings of this study suggest there is an underlying sex difference, further stigmatizing women for alcohol use among the injurypatient population at KCMC. Tanzanian women suffer from unequal access to health care, and the stigmatization of alcohol use likely increases this disparity.
Authors: Bronwyn A Hunter; Nathaniel Vincent Mohatt; Dana M Prince; Azure B Thompson; Samantha L Matlin; Jacob Kraemer Tebes Journal: Soc Sci Med Date: 2017-03-24 Impact factor: 4.634
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