BRIEF RESEARCH REPORT article
Front. Psychol.
Sec. Health Psychology
This article is part of the Research TopicThe Health and Illness Beliefs and Experiences of Minoritized GroupsView all 11 articles
Enacted and internalized stigma as predictors of successful treatment outcome among newly diagnosed tuberculosis patients in Gauteng, South Africa
Provisionally accepted
- 1Public Health Societies and Wellbeing, Human Sciences Research Council, Pretoria, South Africa
- 2Department of Psychology, University of Pretoria, Pretoria, South Africa
- 3Statistical Support Unit: Directorate of Research and Innovation, Tshwane University of Technology, Pretoria, South Africa
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Tuberculosis (TB) is a curable and preventable infectious disease that continues to pose a substantial public health threat. A significant challenge in TB management is poor treatment adherence, which is often linked to stigma. Stigma is widely recognized as a critical factor influencing medication adherence and treatment outcomes. Persons with TB experience stigma. This study examined the predictive ability of enacted and internalized stigma on TB treatment outcomes. Newly diagnosed individuals with TB were purposively enrolled from clinics in the Ekurhuleni District, South Africa. Stigma experiences were assessed at treatment initiation using the Stigma Scale for Chronic Illnesses, administered individually. TB treatment outcomes were obtained from patient records after completion of the treatment period and documented by facility-registered nurses. Successful outcomes were defined as patients who completed treatment or were cured. Bivariate logistic regression models were used to examine the predictive ability of enacted and internalized stigma on TB outcomes. Most participants reported low levels of stigma. A strong relationship was observed between enacted and internalized stigma. The majority of participants achieved favorable TB treatment outcomes. Participants reporting lower levels of both enacted and internalized stigma were more likely to experience favorable outcomes than those reporting higher levels. Both forms of stigma were significantly associated with TB treatment outcomes. Although stigma levels were generally low, enacted and internalized stigma remain essential contributors to TB treatment outcomes. Lower stigma was associated with more favorable outcomes, highlighting the need for stigma-informed policies and interventions to strengthen TB care and improve treatment success.
Keywords: Enacted stigma, Internalized stigma, predictors, South Africa, Successful treatment outcomes, tuberculosis (TB)
Received: 24 Nov 2024; Accepted: 03 Feb 2026.
Copyright: © 2026 Sole-Moloto, Visser, Mostert and Maduna. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tebogo Brenda Sole-Moloto
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