{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:56:32Z","timestamp":1790837792532,"version":"4.1.0"},"update-to":[{"DOI":"10.12688\/f1000research.177509.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000}}],"reference-count":41,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Background Tuberculosis (TB) remains a major global public health challenge, with Indonesia accounting for a substantial proportion of global incident disease. Although previous Indonesian studies have demonstrated the prevalence and consequences of TB-related stigma, less is known about how people receiving TB treatment experience the interconnected processes of internalised, family and public\/social stigma, and how they understand the factors driving stigmatization in everyday life. Aim This study explored stigma and stigmatization experienced by people with TB receiving treatment in two urban healthcare settings in Jakarta, Indonesia. Methods This study used a qualitative descriptive design. Purposive sampling was used to recruit 30 adults receiving TB treatment from a hospital and a public health centre in Jakarta, Indonesia. Data were generated through individual semi-structured interviews conducted in Bahasa Indonesia and analysed using inductive qualitative content analysis. Results Four interrelated themes were identified: (1) internalised stigma or self-stigma; (2) family stigma; (3) public\/social stigma; and (4) reasons for TB stigmatization. Participants described shame and loss of social status, reduced family support, social labelling, isolation and discrimination, including consequences for employment. Stigmatization was attributed particularly to limited knowledge and misconceptions about TB, fear of infection and transmission, and association with HIV\/AIDS. Conclusion TB stigma in these Jakarta settings operated across individual, family and community levels and could remain socially consequential during treatment and anticipated recovery. Stigma-reduction strategies should therefore extend beyond education alone and combine accurate communication about transmission and curability with psychosocial and peer support, family and community engagement, and measures to address social and employment discrimination.<\/ns3:p>","DOI":"10.12688\/f1000research.177509.2","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T07:19:07Z","timestamp":1789629547000},"page":"1130","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["TB Stigma and Stigmatization Experienced by People with Tuberculosis: A Qualitative Study in Jakarta, Indonesia"],"prefix":"10.12688","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1943-7398","authenticated-orcid":false,"given":"Aan","family":"Sutandi","sequence":"first","affiliation":[{"name":"Faculty of Nursing and Midwifery Jakarta Universitas Binawan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henny","family":"Suzana Mediani","sequence":"additional","affiliation":[{"name":"School of Nursing Bandung Padjadjaran University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apriana","family":"Rahmawati","sequence":"additional","affiliation":[{"name":"Faculty of Nursing Java Jember University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari","family":"Narulita","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Midwifery Jakarta Universitas Binawan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryuni","family":"Maryuni","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Midwifery Jakarta Universitas Binawan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma","family":"Refaat Ahmed","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Midwifery Jakarta Universitas Binawan"},{"name":"Faculty of Nursing, College of Health Sciences Sharjah University of Sharjah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5355-8639","authenticated-orcid":false,"given":"Nabeel","family":"Al-Yateem","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Midwifery Jakarta Universitas Binawan"},{"name":"Faculty of Nursing, College of Health Sciences Sharjah University of Sharjah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5196-238X","authenticated-orcid":false,"given":"Muhammad","family":"Arsyad Subu","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Midwifery Jakarta Universitas Binawan"},{"name":"Faculty of Nursing, College of Health Sciences Sharjah University of Sharjah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0048-0553","authenticated-orcid":false,"given":"Richard","family":"Mottershead","sequence":"additional","affiliation":[{"name":"Behavioural Science Institute, SEHA Al Ain Sakina"},{"name":"College of Nursing Baghdad University of Baghdad"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"168-173","DOI":"10.5588\/ijtld.13.0181","article-title":"A systematic review of global cultural variations in knowledge, attitudes and health responses to tuberculosis stigma.","volume":"18","author":"S Chang","year":"2014","journal-title":"The International Journal of Tuberculosis and Lung Disease."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"427-435","DOI":"10.1046\/j.0309-2402.2003.02822.x","article-title":"Rigour and grounded theory research.","volume":"44","author":"R Chiovitti","year":"2003","journal-title":"Journal of Advanced Nursing."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"34-42","DOI":"10.1177\/00333549101250S407","article-title":"Tuberculosis and stigmatization: Pathways and interventions.","volume":"125","author":"A Courtwright","year":"2010","journal-title":"Public Health Reports."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"90-100","DOI":"10.1016\/j.ijid.2016.10.011","article-title":"Tuberculosis stigma as a social determinant of health: A systematic mapping review of research in low-incidence countries.","volume":"56","author":"G Craig","year":"2017","journal-title":"International Journal of Infectious Diseases."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e0119861","DOI":"10.1371\/journal.pone.0119861","article-title":"Assessing the consequences of stigma for people with TB in urban Zambia.","volume":"10","author":"A Cremers","year":"2015","journal-title":"PLOS ONE."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1186\/s12889-019-7915-6","article-title":"Stigma matters in ending tuberculosis: Nationwide survey of stigma in Ethiopia.","volume":"20","author":"D Datiko","year":"2020","journal-title":"BMC Public Health."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1186\/s12889-023-15407-2","article-title":"A qualitative exploration into the presence of TB stigmatization across three districts in South Africa.","volume":"23","author":"D DeSanto","year":"2023","journal-title":"BMC Public Health."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1890-1899","DOI":"10.1111\/phn.70007","article-title":"Unraveling mental health stigma: A qualitative study of health science students\u2019 perceptions toward patients with mental illness in the United Arab Emirates.","volume":"42","author":"J Dias","year":"2025","journal-title":"Public Health Nursing."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"107-115","DOI":"10.1111\/j.1365-2648.2007.04569.x","article-title":"The qualitative content analysis process.","volume":"62","author":"S Elo","year":"2008","journal-title":"Journal of Advanced Nursing."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e0000989","DOI":"10.1371\/journal.pgph.0000989","article-title":"Analysing interventions designed to reduce tuberculosis-related stigma: A scoping review.","volume":"2","author":"I Foster","year":"2022","journal-title":"PLOS Global Public Health."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1038\/s41533-024-00407-5","article-title":"Codeveloping a community-based, peer-led psychosocial support intervention to reduce stigma and depression among people with tuberculosis and their households in Indonesia: A mixed-methods participatory action study.","volume":"35","author":"A Fuady","year":"2025","journal-title":"npj Primary Care Respiratory Medicine."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1186\/s40359-023-01161-y","article-title":"Stigma towards people with tuberculosis: A cross-cultural adaptation and validation of a scale in Indonesia.","volume":"11","author":"A Fuady","year":"2023","journal-title":"BMC Psychology."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e0002489","DOI":"10.1371\/journal.pgph.0002489","article-title":"Stigma, depression, quality of life, and the need for psychosocial support among people with tuberculosis in Indonesia: A multi-site cross-sectional study.","volume":"4","author":"A Fuady","year":"2024","journal-title":"PLOS Global Public Health."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"105-112","DOI":"10.1016\/j.nedt.2003.10.001","article-title":"Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness.","volume":"24","author":"U Graneheim","year":"2004","journal-title":"Nurse Education Today."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"29-34","DOI":"10.1016\/j.nedt.2017.06.002","article-title":"Methodological challenges in qualitative content analysis: A discussion paper.","volume":"56","author":"U Graneheim","year":"2017","journal-title":"Nurse Education Today."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"27-32","DOI":"10.52199\/inj.v13i1.22662","article-title":"Hubungan stigma dengan self esteem pada penderita tuberkulosis paru di Aceh Besar, Indonesia.","volume":"13","author":"R Hadawiyah","year":"2022","journal-title":"Idea Nursing Journal."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1277-1288","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis.","volume":"15","author":"H Hsieh","year":"2005","journal-title":"Qualitative Health Research."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"100233","DOI":"10.1016\/j.jctube.2021.100233","article-title":"\u2018You have to change your whole life\u2019: A qualitative study of the dynamics of treatment adherence among adults with tuberculosis in the United Kingdom.","volume":"23","author":"A Karat","year":"2021","journal-title":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"140-146","DOI":"10.35508\/tjph.v2i3.4037","article-title":"Stigma and family knowledge of people with TB at Naibonat and Oesao Health Center.","volume":"2","author":"K Lay","year":"2021","journal-title":"Timor Leste Journal of Public Health."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"4813-4821","DOI":"10.1111\/jocn.13837","article-title":"Perceived stigma and depression in initially diagnosed pulmonary people with TB.","volume":"26","author":"L Lee","year":"2017","journal-title":"Journal of Clinical Nursing."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"438-439","DOI":"10.1016\/0147-1767(85)90062-8","volume":"9","author":"Y Lincoln","year":"1985","journal-title":"Naturalistic inquiry."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"363-385","DOI":"10.1146\/annurev.soc.27.1.363","article-title":"Conceptualizing stigma.","volume":"27","author":"B Link","year":"2001","journal-title":"Annual Review of Sociology."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1753-1760","DOI":"10.1177\/1049732315617444","article-title":"Sample size in qualitative interview studies: Guided by information power.","volume":"26","author":"K Malterud","year":"2016","journal-title":"Qualitative Health Research."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"841","DOI":"10.12688\/f1000research.153262.3","article-title":"A scoping review of health models for the community mental health needs of the United Arab Emirates: Nurturing the social determinants of mental health through social prescribing in the Middle East [Version 3; peer review: 2 approved].","volume":"13","author":"R Mottershead","year":"2024","journal-title":"F1000Research."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"727-735","DOI":"10.9204\/aogh.2383","article-title":"Exploring manifestations of TB-related stigma experienced by women in Kolkata.","volume":"84","author":"R Mukerji","year":"2018","journal-title":"India. Annals of Global Health."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1186\/s40249-022-01021-8","article-title":"Interventions pathways to reduce tuberculosis-related stigma: A literature review and conceptual framework.","volume":"11","author":"C Nuttall","year":"2022","journal-title":"Infectious Diseases of Poverty."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1275-1288","DOI":"10.1177\/1049732315588083","article-title":"Factors influencing delayed health care seeking among pulmonary tuberculosis suspects in rural communities in Ntcheu District, Malawi.","volume":"26","author":"P Nyasulu","year":"2016","journal-title":"Qualitative Health Research."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1245-1251","DOI":"10.1097\/ACM.0000000000000388","article-title":"Standards for reporting qualitative research: A synthesis of recommendations.","volume":"89","author":"B O\u2019Brien","year":"2014","journal-title":"Academic Medicine."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1789-1798","DOI":"10.1111\/hsc.13287","article-title":"Their place is beyond the town\u2019s border\u2019: A qualitative exploration of stigma associated with tuberculosis in rural and urban areas of Lagos, Nigeria.","volume":"29","author":"D Oladele","year":"2021","journal-title":"Health & Social Care in the Community."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"165-171","DOI":"10.1016\/j.anr.2014.02.006","article-title":"Family stigma: A concept analysis.","volume":"8","author":"S Park","year":"2014","journal-title":"Asian Nursing Research."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1903","DOI":"10.1186\/s12889-021-12005-y","article-title":"Barriers and strategies to successful tuberculosis treatment in a high-burden tuberculosis setting: A qualitative study from the patient\u2019s perspective.","volume":"21","author":"I Pradipta","year":"2021","journal-title":"BMC Public Health."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"334-340","DOI":"10.1002\/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G","article-title":"Whatever happened to qualitative description?","volume":"23","author":"M Sandelowski","year":"2000","journal-title":"Research in Nursing & Health."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"77-84","DOI":"10.1002\/nur.20362","article-title":"What\u2019s in a name? Qualitative description revisited.","volume":"33","author":"M Sandelowski","year":"2010","journal-title":"Research in Nursing & Health."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"101337","DOI":"10.1016\/j.ssmph.2023.101337","article-title":"Developing a tool to measure tuberculosis-related stigma in workplaces in Indonesia: An internal validation study.","volume":"21","author":"D Soemarko","year":"2023","journal-title":"SSM - Population Health."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"S81-S86","DOI":"10.5588\/ijtld.16.0788","article-title":"Evidence-based interventions to reduce tuberculosis stigma: A systematic review.","volume":"21","author":"N Sommerland","year":"2017","journal-title":"The International Journal of Tuberculosis and Lung Disease."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1186\/s12916-019-1271-3","article-title":"The Health Stigma and Discrimination Framework: A global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas.","volume":"17","author":"A Stangl","year":"2019","journal-title":"BMC Medicine."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"2327103","DOI":"10.1080\/17482631.2024.2327103","article-title":"Exploring mental health stigma among Indonesian healthcare students towards individuals with mental illnesses: A qualitative study.","volume":"19","author":"M Subu","year":"2024","journal-title":"International Journal of Qualitative Studies on Health and Well-being."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"349-357","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups.","volume":"19","author":"A Tong","year":"2007","journal-title":"International Journal for Quality in Health Care."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"313-316","DOI":"10.1007\/s10433-010-0168-y","article-title":"Language differences in qualitative research: Is meaning lost in translation?","volume":"7","author":"F Nes","year":"2010","journal-title":"European Journal of Ageing."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s12879-020-4816-3","article-title":"Unpacking the dynamics of double stigma: How the HIV-TB co-epidemic alters TB stigma and its management among healthcare workers.","volume":"20","author":"E Wouters","year":"2020","journal-title":"BMC Infectious Diseases."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"210-222","DOI":"10.1080\/17441692.2020.1855460","article-title":"Behavioural barriers and perceived trade-offs to care-seeking for tuberculosis in the Philippines.","volume":"17","author":"E Zimmerman","year":"2022","journal-title":"Global Public Health."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/15-1130\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/15-1130\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/15-1130\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:09:09Z","timestamp":1790834949000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/15-1130\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":41,"URL":"https:\/\/doi.org\/10.12688\/f1000research.177509.2","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/f1000research.177509.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.209100.r522090","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.209100.r522089","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.209100.r522089","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.209100.r522090","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/15-1130\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.209100.r522090, Shwikar Othman, University of South Australia, Adelaide, South Australia, 21 Sep 2026, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/15-1130\/v2#referee-response-522090","order":0,"name":"referee-response-522090","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Dr. Richard Mottershead<\/b>; \n<i>Posted: 30 Sep 2026<\/i>; On behalf of the research team, I would like to thank Dr. Shwikar Othman for her expert advise and guidance on improving this enhanced version of our manuscript.&nbsp;  Again, thank you&nbsp;  Dr. Richard Mottershead","URL":"https:\/\/f1000research.com\/articles\/15-1130\/v2#referee-comment-17291","order":1,"name":"referee-comment-17291","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.209100.r522089, Tintin Sukartini, Universitas Airlangga, Surabaya, East Java, 25 Sep 2026, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/15-1130\/v2#referee-response-522089","order":2,"name":"referee-response-522089","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Dr. Richard Mottershead<\/b>; \n<i>Posted: 30 Sep 2026<\/i>; On behalf of the research team, we would like to thank Dr. Tintin Sukartini for his expert review of our research and his assisatnce in guiding its development to an enhanced version which is able to better showcase our work.  kindest regards&nbsp;  Dr. Richard Mottershead","URL":"https:\/\/f1000research.com\/articles\/15-1130\/v2#referee-comment-17292","order":3,"name":"referee-comment-17292","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}