Asian Americans comprise just 6% of the U.S. population, but they represent over 60% of Americans with hepatitis B. Hepatitis B (HBV) is a virus that infects the liver, and while some people may recover from the infection, others can go on to develop liver failure or cancer. HBV is transmitted through blood, semen or other bodily fluids, but it can also be passed from mother to child during birth, which is how the majority of Asian Americans acquire the disease.

Up until 2010, laws in China allowed for discrimination against people with HBV, barring adults from employment and keeping children out of school. Though these policies are now outlawed, there remains a stigma against the disease in both China and the U.S.

Researcher Hee-Soon Juon, MSN, Ph.D., at Thomas Jefferson University has been working with Asian-American communities to investigate and raise awareness of HBV since the early 2000s. In a new study published in The Journal of Viral Hepatitis, she and her research team explore how stigma against HBV affects those with the condition.

The study surveyed 365 Korean-Americans with chronic hepatitis B (CHB) to see how stigma against HBV affected them. Participants responded to questions about their physical health, mental health and if they believed they had experienced racial discrimination.

Dr. Juon found that people who felt more stigmatized were more likely to report worse depression and physical health, and that greater knowledge of the disease didn’t necessarily translate to feeling less judged for their condition. Perceived racial discrimination was also tied to feelings of stigma and depression.

“We confirmed that stigma is very impactful for a CHB patient,” says Dr. Juon. “This can have consequences on their treatment journey.”

In fact, past research has shown that stigma against a disease may dissuade individuals from seeking care, cause mental distress or lead to explicit discrimination. Dr. Juon says the next steps in this research will be developing interventions that can help combat stigma for those with HBV.