Date of Conferral

5-9-2024

Date of Award

May 2024

Degree

Ph.D.

School

Public Health

Advisor

David Segal

Abstract

About 80% of active tuberculosis (TB) cases are caused by untreated latent tuberculosis infection (LTBI), with most being foreign-born United States residents. Despite the availability of preventive therapies, African immigrants living in the United States are hesitant to accept LTBI treatment. Although researchers have explored LTBI treatment hesitancy among foreign-born United States citizens, no study has explored the perspectives of African immigrants living in the United States. This generic qualitative study explored the perception of African immigrants living in the United States on LTBI treatment hesitancy. Participants’ inclusion criteria include those 18 years and older with a positive TB test, reside in the United States, speak English, and have access to videoconference. Data were collected through face-to-face remote interviews using semi-structured interview questions guided by the Anderson healthcare utilization model. Participants were recruited through LinkedIn, and eight participants were interviewed. Seven themes emerged. (1) LTBI treatment hesitancy is common among African immigrants in the United States, (2) LTBI treatment is not necessary, (3) Treatment hesitancy is caused by inadequate information on LTBI treatment, (4) LTBI treatment is imposed, (5) The government is not trustworthy, (6) LTBI treatment has harmful side effects, and (7) LTBI treatment is an instrument of stigmatization and discrimination. This qualitative study's new insight is treatment imposition, which raises awareness about the need to educate patients about their choices and respect their preferences. The findings of this study could be used to develop strategies to improve acceptance of LTBI treatment, prevent active TB, and contribute to the global goal of eradicating TB by 2035.

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