Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 1, 2022
Date Accepted: May 24, 2023
Cross-sectional Analysis of perceived stigma towards tuberculosis and acceptance of preventive treatment among college students with latent tuberculosis infection in an eastern province of China: The moderating role of gender
ABSTRACT
Background:
With the increasing enrollment scale of colleges, the number of students on campus has risen sharply in China. The number of students with tuberculosis (TB) and rifampicin-resistant TB in colleges has increased significantly. Preventive treatment of latent tuberculosis infection (LTBI) is an important means for TB prevention and control in colleges. At present, the acceptance of LTBI treatment among college students remains unclear. In addition, evidence shows stigma may be one of the key factors affecting acceptance of LTBI treatment. To date, there is little direct evidence on the association between perceived stigma towards TB and acceptance of LTBI treatment among college students, as well as known about the gender-specific association.
Objective:
This study aimed to describe the acceptance of LTBI treatment among college students in an eastern province of China, to explore the association between perceived stigma towards TB and acceptance of LTBI treatment, and to examine the moderating effect of gender on the association.
Methods:
Data were derived from the project on treatment and effectiveness evaluation of LTBI among college students in Shandong, China. In total, 1,547 college students were included in the analysis. We considered covariates at the individual and family levels. Multilevel mixed-effects logistic regression was used to examine the moderating roles of gender, then further to explore the association between perceived stigma towards TB and acceptance of LTBI treatment.
Results:
The acceptance rate of college students diagnosed with LTBI was 46.7%.The proportion of female students (51.5%) accepting LTBI treatment was higher than that of male students (42.8%; P=.001). There was an interaction in perceived stigma towards TB and gender (OR=0.93, 95%CI 0.87-1.00, P=.059). Among LTBI college students, perceived stigma towards TB was positively associated with acceptance of preventive treatment (OR=1.03, 95%CI 1.00-1.08, P=.050). Perceived stigma towards TB was positively associated with accepting LTBI treatment only among male students (OR=1.07, 95%CI 1.02-1.12, P=.005).
Conclusions:
The acceptance rate of preventive treatment among LTBI college students was low. Contrary to our expectations, perceived stigma towards TB was positively associated with acceptance of preventive treatment. Gender moderated this association, and high perceived stigma towards TB was associated with acceptance of preventive treatment only in male gender. Gender-specific strategies are effective in improving the acceptability of LTBI treatment in colleges.
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