Table 3.
Characterization of SCD stigma based on the health stigma and discriminatory framework
| Domains in the health stigma and discriminatory framework | Description of domains | Illustrative examples of SCD-related Stigma |
|---|---|---|
| Drivers of SCD-related Stigma | Inherently negative influences that drive health-related stigma | Frequent crises and hospitalizations |
| Discrimination based on physical features (e.g. yellow eyes) | ||
| Association of SCD to early mortality | ||
| Social judgement | ||
| Self-blame and denial | ||
| Hereditary nature of SCD leads to stigmatization of families | ||
| Regular need for blood transfusions | ||
| Being called a Sickler | ||
| Facilitators of SCD-related stigma | Positive or negative influences that drive health-related stigma | Supernatural beliefs on the causes of SCD (witchcraft) |
| Cultural beliefs | ||
| Pity/sympathy from peers and the community | ||
| Viewed as weak | ||
| Manifestations of SCD-related stigma | Experiences and practice of stigmatization | Employment discrimination |
| Social isolation (friends and peers) | ||
| Internalization of stigma | ||
| Discrediting narratives of SCD | ||
| Discourteous treatment at health facilities, schools, workplace, and community | ||
| Social discrimination in intimate relationships | ||
| Outcomes of SCD-related stigma | Explicit bias by healthcare workers negatively impacts the health-seeking behaviour of persons living with SCD | |
| Status loss: patients feel diminished and valueless | ||
| Challenges integrating people living with SCD into the workplace Othering |