Adults with confirmed chronic hepatitis B described pervasive stigma that affected self-perception, social roles, and interactions with health systems. Across the sample, internalized stigma was universal. Many participants also described experiences of social stigma and institutional stigma, and several reported overlapping or interconnected experiences across stigma types. The original publication presents figures that summarize the distribution of stigma types and domain-level concepts reported by participants.
This qualitative study recruited 28 adult participants with a confirmed diagnosis of chronic hepatitis B from three countries: the United States (n = 11), China (n = 11), and Poland (n = 6). Research interviews were semi-structured, concept elicitation sessions of approximately 60 minutes each, focused on participants’ lived experiences related to stigma. Thematic Analysis methods were used to analyze interview transcripts and to categorize emergent concepts into domains and into pre-determined stigma types.
Stigma types were categorized as internalized, social, or institutional. Reported frequencies in this sample were:
The study authors emphasize that internalized stigma was both the most common and the most personally bothersome form of stigma for participants.
Seven domains spanning condition-specific concerns and broader health-related quality of life (HRQoL) were identified from participant reports and formed a patient-centric conceptual model. Each domain was reported by at least half of participants. The most frequently reported domain-level concepts were:
Social functioning: reported by 28 of 28 participants (100%). Descriptions included altered relationships, social withdrawal, or felt exclusion related to HBV status.
Emotional wellbeing: reported by 27 of 28 participants (96%). Participants described negative emotions, reduced psychological wellbeing, shame, or reduced self-esteem.
HBV transmission concerns: reported by 27 of 28 participants (96%). Worries about infecting others, anxiety around casual contact, and misunderstandings about transmission were frequently described.
Other domains identified in the conceptual model included aspects of daily functioning, physical health perceptions, healthcare interactions, and condition-specific impacts; each domain included multiple specific concepts reported by participants.
Participants often reported multiple concepts within a domain and multiple domains overall, illustrating that experiences of stigma were highly inter-related. The conceptual model presented in the original article maps associations between condition-specific concepts (such as transmission concerns) and HRQoL outcomes (such as emotional wellbeing and social functioning). The authors note that these interconnections contribute to cumulative burden and can amplify adverse effects on wellbeing and behavior, including avoidance of social contact and reluctance to engage with healthcare providers.
Findings indicate that HBV-related stigma is widespread and has a substantial negative effect on HRQoL. Reported outcomes included reduced social participation, emotional distress, and behavioral consequences such as decreased willingness to seek or continue healthcare. The authors suggest that interventions to reduce stigma—especially efforts that target internalized stigma—could yield the most meaningful improvements because internalized stigma was both ubiquitous and highly bothersome to participants.
This research used qualitative, semi-structured interviews and Thematic Analysis to elicit and categorize concepts into domains and stigma types. The sample included adults from three countries but comprised 28 participants total; the publication describes domain frequencies and presents a patient-centric conceptual model. The source text reports participant counts and percentages for stigma types and domain-level reporting. Details such as recruitment methods, interview guides, coding procedures, and saturation thresholds are described in the original full text; where specific procedural details were not included in the abstract excerpt, those details are not reported here.
The study was funded by GSK. Several authors were employees of GSK or Adelphi Values Ltd., the contracted health-outcomes agency; Adelphi Values received funding from GSK to conduct the research. The publication lists additional references and figures (including a conceptual model and figures showing domain associations) in the full article. The summary presented here reflects the content and results reported in the source abstract and accompanying article metadata.