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American Journal of Public Health Research. 2025, 13(2), 45-53
DOI: 10.12691/ajphr-13-2-2
Open AccessLiterature Review

The Weight of Stigma: Gendered Mental Health Burdens in Multi-Drug-Resistant TB and the Path Forward Through Patient-Centric Community Care Models

Judith Mueller1, 2,

1The George Washington University Milken Institute School of Public Health, Washington, DC

2The Mueller Health Foundation, New York, NY

Pub. Date: March 18, 2025
View Full Text Full Text PDF (212 KB) Full Text ePUB(201 KB)

Cite this paper:
Judith Mueller. The Weight of Stigma: Gendered Mental Health Burdens in Multi-Drug-Resistant TB and the Path Forward Through Patient-Centric Community Care Models. American Journal of Public Health Research. 2025; 13(2):45-53. doi: 10.12691/ajphr-13-2-2

Abstract

Multidrug-resistant tuberculosis (MDR TB) constitutes a substantial public health challenge, particularly in low- and middle-income countries (LMICs), where adherence to treatment is complicated by psychological distress and social stigma. Women, who represent nearly half of MDR TB cases, encounter disproportionate mental health burdens stemming from gender-specific stigma and social isolation. This narrative literature review investigates the intersection of stigma, mental health, and gender within the context of MDR TB care, underscoring the importance of patient-centered community care models as a viable intervention. A narrative review encompassing 76 peer-reviewed articles was undertaken utilizing databases such as PubMed, Elsevier, and Google Scholar, with the application of stringent inclusion criteria centered on gendered psychological burdens and interventions related to stigma. The findings have been classified into three thematic areas: (1) an exploration of the psychological burden of MDR TB through a gender-focused perspective, (2) an analysis of stigma as a principal social stressor through a gendered lens, and (3) an evaluation of mental health and anti-stigma interventions within community-based care frameworks. Research has indicated that patients with MDR TB often experience symptoms of depression and anxiety. Women, in particular, are at an elevated risk attributed to societal expectations, insufficient social support, and responsibilities related to family caregiving. Furthermore, stigma exacerbates this challenge, diminishing adherence to treatment protocols and resulting in inferior health outcomes. In response to these issues, community-based care models that integrate mental health support, stigma reduction initiatives, and patient-centered interventions have exhibited the potential to enhance both psychological well-being and treatment efficacy. Despite these findings, important research gaps remain, such as the absence of extensive quantitative studies on the effects of stigma, the need for gender-specific mental health interventions, and the development of standardized stigma measurement tools in MDR TB. This review highlights the importance of incorporating gender-responsive psychosocial interventions into MDR TB treatment frameworks and advocates for a shift towards comprehensive, patient-centered community care models aimed at reducing stigma and improving treatment adherence for both men and women.

Keywords:
Tuberculosis Community Care Models Mental Health Stigma Multi-Drug Resistance

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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