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Volume 30, Number 3—March 2024
Research

Systematic Review of Scales for Measuring Infectious Disease–Related Stigma

Amy PatersonComments to Author , Ashleigh Cheyne, Benjamin Jones, Stefan Schilling, Louise Sigfrid, Jeni Stolow, Lina Moses, Piero Olliaro, and Amanda Rojek
Author affiliations: University of Oxford, Oxford, UK (A. Paterson, A. Cheyne, B. Jones, S. Schilling, L. Sigfrid, P. Olliaro, A. Rojek); Tulane University, New Orleans, Louisiana, USA (J. Stolow, L. Moses); Global Outbreak Alert and Response Network, World Health Organization, Geneva, Switzerland (J. Stolow, L. Moses); The Royal Melbourne Hospital, Melbourne, Victoria, Australia (A. Rojek)

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Table 3

Definitions and example scale items for each domain identified in a systematic review of scales for measuring infectious disease–related stigma*

Action-oriented stigma domains† Experiential stigma domains
Prejudice‡ Discrimination§ Medically unwarranted avoidance¶
Social: stigmatization by friends and family
 “I feel blamed by relatives or friends,” Self-stigma Scale (SSS-15)
 “[I was] forced to change residence because of social alienation,” 7-item EVD-related stigma index
 “People I cared for stopped calling or interacting after learning that I was infected/suspected,” COVID-19 Stigma Scale
Public: stigmatization by broader community and strangers
 “Most people think that a person who has had Ebola is disgusting,” Ebola/COVID-19–related Stigma Survey
 “I have been insulted/discriminated because of my history of being infected/suspected,” COVID-19 Stigma Scale
 “Some people avoid touching me even after my recovery once they knew I was infected with/suspected,” COVID-19 stigma scale
Workplace: stigmatization by colleagues and employers
 “My feeling of job security has been affected by my illness,” COVID-19 Perceived Stigma Scale-22 (CPSS-22)
 “I will dismiss my employee who recovers from COVID-19,” Social stigma and discriminatory attitudes scale
 “Someone refused to buy products from you,” Stigmatization related to EVD and COVID-19 scale
Provider-related: stigmatization by service providers
 “You feel it is not worthwhile for you to serve persons who contracted COVID-19” - Stigma Discrimination Scale (SDS-11)
 “[I was] treated unfairly by healthcare professionals,” COVID-19 Experienced DISCrimination Scale (CEDISC)
 “I was denied health care services when the doctors found out I was infected /suspected,” COVID-19 Stigma Scale
Structural: stigmatization by institutions
 NA
 “The first COVID-19 patient in each city should be identified and penalised due to their role in spreading the disease,” COVID-19-related enacted Stigma Questionnaire
 “At the hospital/clinic, I was made to wait until the last,” Ebola-related stigma instrument
Self: internalization of stigma “Having had COVID-19 infection makes me feel that I am a bad person,” COVID-19-related Stigma Survey “I stopped eating with other people,” Ebola-related stigma instrument NA
Anticipated; disclosure concerns or avoidance due to fear of stigma
 “I worry that people may judge me negatively when they find out I have long Covid,” Long COVID Stigma Scale (LCSS)
 “You have avoidance behaviours such as staying home for fear of being stigmatised or rejected,” Stigmatization related to EVD and COVID-19 scale
 NA
Stigma-by-association; stigmatization of those societally associated with the disease or infected persons but not personally infected “If they knew about it would your neighbors, colleagues or others in your community think less of your family because of your COVID-19 infection?” Arabic Explanatory Model Interview Catalogue (EMIC) “A school refused to accept your children,” Stigmatization related to EVD and COVID-19 scale “If a person was infected with COVID-19, it is better to avoid his/her family members,” Community COVID-19 Stigma Scale

*Framework based on stigma typology from Jones and Corrigan (6). EVD, Ebola virus disease; NA, not applicable. †Domains adopted from Pescosolido and Martin (27). ‡Negative thoughts and feelings toward stigmatized persons. §Enactment of prejudice or differential treatment of stigmatized persons. ¶Neglect of stigmatized persons.

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Page created: December 31, 2023
Page updated: February 22, 2024
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