Paper long abstract:

Haitian immigrants to the United States face complex public identities associated with infectious diseases, poverty, discrimination and related stereotypes. These identities influence social reactions to stigmatized diseases such as tuberculosis. However, anticipated stigma may vary according to one's social position within the immigrant community. This paper reports findings of a cultural epidemiologic study of TB-related stigma expectations in three South Florida comparison groups: persons of Haitian origin diagnosed with latent TB, non-affected members of the Haitian community, and health care providers who work with Haitian patients. Differences in degree and components of anticipated stigma across groups are described using ethnographic and survey data. Non-affected community members and health care providers report higher anticipated stigma than do patients themselves, and the dimensions of TB stigma also vary across groups. Alternative explanations for these differences are discussed in terms of the implications for stigma theory and health policy.