02369nas a2200289   4500000000100000008004100001653001300042653000800055653003600063653002700099653001100126653002800137653001700165100001200182700001400194700001400208700001800222700002300240700001500263700001200278245011700290856007800407300000700485490000700492520156600499022001402065       2019                            d10aEpilepsy10aHIV10aLow and middle income countries10aMental health problems10aStigma10aStigma (health related)10aTuberculosis1 aKane JC1 aElafros M1 aMurray SM1 aMitchell EM H1 aAugustinavicius JL1 aCausevic S1 aBaral S00aA scoping review of health-related stigma outcomes for high-burden diseases in low- and middle-income countries.  uhttps://bmcmedicine.biomedcentral.com/track/pdf/10.1186/s12916-019-1250-8  a170 v173 a<p><strong>BACKGROUND: </strong>Stigma is associated with health conditions that drive disease burden in low- and middle-income countries (LMICs), including HIV, tuberculosis, mental health problems, epilepsy, and substance use disorders. However, the literature discussing the relationship between stigma and health outcomes is largely fragmented within disease-specific siloes, thus limiting the identification of common moderators or mechanisms through which stigma potentiates adverse health outcomes as well as the development of broadly relevant stigma mitigation interventions.</p>

<p><strong>METHODS: </strong>We conducted a scoping review to provide a critical overview of the breadth of research on stigma for each of the five aforementioned conditions in LMICs, including their methodological strengths and limitations.</p>

<p><strong>RESULTS: </strong>Across the range of diseases and disorders studied, stigma is associated with poor health outcomes, including help- and treatment-seeking behaviors. Common methodological limitations include a lack of prospective studies, non-representative samples resulting in limited generalizability, and a dearth of data on mediators and moderators of the relationship between stigma and health outcomes.</p>

<p><strong>CONCLUSIONS: </strong>Implementing effective stigma mitigation interventions at scale necessitates transdisciplinary longitudinal studies that examine how stigma potentiates the risk for adverse outcomes for high-burden health conditions in community-based samples in LMICs.</p>
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