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Georgetown University

Publication Date

Spring 2023

Program Name

India: Public Health, Gender, and Community Action


HIV and tuberculosis are highly impactful diseases in India, causing severe morbidity, mortality, and suffering for millions. The stigmatization of these diseases unnecessarily exacerbates suffering for those afflicted and their families, compounding to the existing physical and emotional burden of diagnosis. Individual interviews with healthcare workers were conducted at Delek Hospital and the Tibetan Children’s Village in order to identify the existence and effects of stigma in the Tibetan refugee population in Dharamshala. Respondents reported an extremely high burden of tuberculosis in the community, complicated by the refugee status and unique infrastructural challenges of the population. The burden of HIV in the community is remarkably low, although it may be underreported. All healthcare workers noted the tangible influence of stigma, yet many believed that stigma has decreased as the disease has become normalized. Respondents reported highly detrimental consequences to patient mental health as a result of both disease diagnosis and stigmatization, ranging from elevated anxiety and depression to isolation and suicide. Finally, stigmatization of both tuberculosis and HIV are connected with four major behavioral consequences in patients: delayed healthcare visits, resistance to disclosing their diagnosis, traveling to far-away hospitals, and refusal to follow treatment regimens. Stigmatization, and its consequences to patient mental health and disruption of healthcare- seeking behaviors, serves as a dangerous barrier to effective public health interventions and disease elimination in Dharamshala.


Asian Studies | Infectious Disease | International Public Health | Medicine and Health | Psychiatric and Mental Health


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