Settings, Characteristics, and Experiences of Stigma Among People with Tuberculosis in Kenya: Nation

Abstract Background Tuberculosis (TB)-related stigma remains a significant barrier to TB care and treatment adherence in Kenya. Despite progress in TB control, stigma continues to affect individuals diagnosed with TB and their families, leading to delayed healthcare-seeking behaviors, social exclusion, and economic consequences. This study examines the dimensions of TB-related stigma among people infected and affected by TB in Kenya. Methods A cross-sectional study was conducted in November 2023. Data were collected from people with TB (PWTB) in 180 health facilities, across 11 counties in Ken

ya. A multistage stratified sampling method was employed to ensure regional representation. Stigma levels were assessed using a structured stigma index, and multivariate logistic regression was used to analyze factors associated with stigma. Results A total of 367 PWTB were included in the analysis. Most (67%) were men and the median age was 35 years. The study found high levels of community stigma (68%), family stigma (52%), healthcare system stigma (51%) and self-stigma (49%). Many PWTB reported concealing their diagnosis due to fear of discrimination, while families and communities often di

stanced themselves from individuals with TB. Conclusion TB-related stigma in Kenya is prevalent across multiple dimensions, affecting individuals, families, communities, and healthcare systems. Addressing stigma requires targeted interventions, including awareness campaigns, stigma reduction training for healthcare workers, and policy reforms to promote inclusive and supportive TB care environments.