It is well described in current literature that Hepatitis B virus (HBV) affects Asian Americans more than any other racial group in the United States and that there is a stigma attached to this condition. The effects of stigma can be lasting, penetrating physiologically and psychologically, yet few studies have focused on the consequences of this phenomenon. The purpose of this study was to examine the mediating role of stigma in the effect of racial discrimination and knowledge (of HBV sequelae) on health status of Korean Americans with chronic hepatitis B (CHB). Three hundred sixty‐five CHB patients were recruited and enrolled from two clinics in Philadelphia and Los Angeles. Depressive symptoms were measured using the Patient Health Question‐9 (PHQ‐9), physical health via self‐rated health survey and stigma via hepatitis B quality of life (HBQOL)—stigma survey. Perceived racial discrimination and knowledge of CHB sequelae were independent variables. The cohort had an average age of 60.1 years (range 19–84, SD 10.7), 56% were male and 94% were born in South Korea. Mediational analysis found that stigma was a significant mediator between both racial discrimination (indirect effect = .037, Bootstrap 95% CI = [.010–.064]) and sequelae knowledge (indirect effect = .097, Bootstrap 95% CI = [.018–.176]) and depressive symptoms. Stigma also had a direct effect on depressive symptoms (β = .136, p < .01) and self‐rated health (β = .018, p < .05). In addition, age, gender, education and employment were related to health outcomes. The findings of this study indicate that HBV‐related stigma is an important mediator of mental health outcomes in this population. Future studies should identify other psychosocial factors to develop effective intervention programs to reduce stigma and improve quality of life among CHB patients.

中文翻译：

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种族歧视、知识和健康结果：乙型肝炎相关耻辱在慢性乙型肝炎患者中的中介作用

目前的文献充分描述了乙型肝炎病毒 (HBV) 对亚裔美国人的影响比美国任何其他种族群体都要大，而且这种情况存在耻辱。耻辱的影响可能是持久的，渗透到生理和心理上，但很少有研究关注这种现象的后果。本研究的目的是探讨耻辱在种族歧视和知识（乙型肝炎后遗症）对患有慢性乙型肝炎（CHB）的韩裔美国人健康状况影响中的中介作用。从费城和洛杉矶的两家诊所招募并登记了 365 名慢性乙型肝炎患者。使用患者健康问题 9 (PHQ-9) 测量抑郁症状，通过自评健康调查测量身体健康，通过乙型肝炎生活质量 (HBQOL) 耻辱调查测量耻辱感。感受到的种族歧视和对慢性乙型肝炎后遗症的了解是自变量。该队列的平均年龄为 60.1 岁（范围为 19-84 岁，标准差为 10.7），其中 56% 为男性，94% 出生于韩国。中介分析发现，耻辱是种族歧视（间接效应 = .037，Bootstrap 95% CI = [.010–.064]）和后遗症知识（间接效应 = .097，Bootstrap 95% CI = [.010–.064]）之间的显着中介因素。 018–.176]）和抑郁症状。耻辱也对抑郁症状有直接影响（β= .136,p< .01) 和自评健康 (β= .018,p< .05)。此外，年龄、性别、教育和就业也与健康结果有关。这项研究的结果表明，与乙型肝炎相关的耻辱是该人群心理健康结果的重要调节因素。未来的研究应确定其他心理社会因素，以制定有效的干预计划，以减少慢性乙型肝炎患者的耻辱感并提高生活质量。