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      Influence of social experiences in shaping perceptions of the Ebola virus among African residents of Hong Kong during the 2014 outbreak: a qualitative study

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          The outbreak of Ebola virus disease (EVD) in Africa in 2014 attracted worldwide attention. Because of the high mortality rate, marginalised social groups are vulnerable to disease-associated stigmatisation and discrimination, according to the literature. In Hong Kong, ethnic minorities such as Africans are often disadvantaged groups because of their low position in the social hierarchy. In 2011, approximately 1700 Africans were residing in Hong Kong. Their overseas experiences during the EVD outbreak were not well documented. Therefore, this study investigated the EVD-associated stigmatisation experiences of African residents of Hong Kong with chronic illnesses, and how these experiences shaped their perceptions of EVD.


          A qualitative design with 30 in-depth semistructured interviews was conducted with chronically ill African residents of Hong Kong.


          The interview data showed that the sampled Africans often experienced stigmatisation in their workplaces and in the community during the EVD outbreak. Their experiences of EVD-associated stigma were correlated to the embedded social and cultural values regarding ethnic minorities in Hong Kong. These experiences of being stigmatised shaped the perceptions of the Africans of EVD, leading them to view EVD as shameful and horrifying. They also perceived EVD as retribution and was introduced by Westerners. The participants’ perceptions of EVD influenced their responses to and behaviour towards EVD, which may have posed potential threats to Hong Kong’s public health.


          The EVD outbreak was not the only cause of the participants’ stigmatisation; rather, their EVD-associated experiences were a continuation and manifestation of the embedded social and cultural values regarding ethnic minorities in Hong Kong. The experiences of being stigmatised shaped the participants’ perceptions of EVD. Because of their marginalised social position and isolation from the main community, the participants had extremely limited access to reliable information about EVD. As a result, they used their own cultural beliefs to understand EVD, which might have ultimately influenced their health behaviours. The experiences of the participants showed that ethnic minorities in Hong Kong were in need of more culturally responsive social and health care support to obtain reliable information about the nature of and preventive measures against EVD.

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          Most cited references 16

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              Pathways to treatment for tuberculosis in Bali: patient perspectives.

              The authors explored treatment-seeking behavior among people with tuberculosis (TB) in Bali, Indonesia. They conducted in-depth interviews with 5 people who had been diagnosed with TB and 6 people who were suspected of having TB but who had not yet received a diagnosis. Participants reported frequent delays in obtaining a diagnosis of TB and obtaining adequate treatment. The authors describe issues associated with treatment-seeking behavior using the following five main themes: awareness of TB-causes, symptoms, and seriousness; influence of others; treatment quality; treatment barriers and default; and stigma and fear. Their findings reinforce the importance of a comprehensive TB control program that provides quality diagnostic and treatment services, and patient and community education, and enables patient involvement in treatment.

                Author and article information

                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                5 October 2015
                5 October 2015
                : 14
                David C. Lam Institute for East–West Studies (Environment, Health, and Sustainability working group), Hong Kong Baptist University, Kowloon Tong, Hong Kong
                © Siu. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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