Tuberculosis and AIDS stigma among patients who delay seeking care for TB symptoms

Background—Delay in presentation to a health facility is an important concern for TB control. The effect of stigma on delay in seeking care for TB symptoms is not well studied, especially in the context of the HIV co-epidemic. Objective—To estimate the association of TB and AIDS stigma on delay in seeking care for TB symptoms. Setting/Design—For 480 newly diagnosed patients with TB, time from first TB symptom to the first visit to a qualified provider was calculated. Stigma scales were administered to each patient to obtain a stigma score. Results—Among men, those with higher TB stigma had a small increase in delay times, while women had a small decrease in delay. Among patients presenting with hemoptysis, higher TB stigma was associated with a small increase in delay, while among patients presenting with fever or extrapulmonary symptoms only, higher TB and AIDS stigma resulted in shorter delay times. Conclusion—In a population with a relatively short median delay (26 days), the impact of TB and AIDS stigma translates into a minimal change in delay time. This suggests that stigma does not have a clinically relevant effect on TB patient delay in southern Thailand