A Mixed Methods Study: Sex Differences in Experiences of Stigma Associated with Alcoholism and Alcohol Use Disorders Among Injury Patients in Tanzania

Citation: 
S. Michelle Griffin, Francis P. Karia, Armand Zimmerman, Mary Catherine C. Minnig, Monica Swahn, Jennifer Makelarski, Blandina Mmbaga, Joao Ricardo Nickenig Vissoci, Catherine Staton
Publication year: 
2020

Background

Each year, alcohol use causes 3.3 million deaths globally and accounts for nearly 30% of injuries treated at Kilimanjaro Christian Medical Center (KCMC) in Moshi, Tanzania. Prior research found significant stigma towards patients reporting alcohol use in general and among healthcare providers for this population.

Methods

This mixed‐methods study aimed to identify sex‐based perspectives of stigma among injury patients, family members, and local community advisory board members. Injury patients from the emergency room at KCMC were asked to complete surveys capturing consumption of alcohol, perceived stigma, and consequences of drinking. Patients who completed the survey, their family members, and members of a community advisory board were also recruited to take part in focus groups led by a trained bilingual research nurse. Data were analyzed using multiple linear regression and Wilcoxon rank sum tests with alpha level set at 0.05.

Results

Results showed that sex was a significant predictor of perceived discrimination (p = 0.037, SE =1.71(0.81)) but not for perceived devaluation (p = 0.667, SE = ‐0.38(0.89)). Focus groups revealed there were global negative perceptions of the amount of alcohol consumed as well as negative perceptions towards disclosure of alcohol use to healthcare providers. Sex differences in stigma emerged when participants were specifically asked about women and their alcohol consumption.

Conclusions

The findings of this study suggest there is an underlying sex difference, further stigmatizing women for alcohol use among the injury patient population at KCMC. Tanzanian women suffer from unequal access to healthcare and the stigmatization of alcohol‐use likely increases this disparity.