OBJECTIVETo analyze the present situation and influencing factors of discrimination against hepatitis B patients and carriers among rural adults in three eastern provinces in China.

METHODSBy using the method of probability proportionate to size (PPS), we involved a sample of 9 269 rural adults aged above 18 years old from 22 villages of 7 counties in Beijing, Hebei, Shandong in 2011 and 2012. We used a self-designed interview questionnaire with questions about the individual and household characteristics, attitudes toward hepatitis B patients and carriers, individual HBV vaccination history, etc. We analyzed the hepatitis B discrimination score and its distribution, and we also created a multinomial logistic regression model to analyze the influencing factors of discrimination.

RESULTSOf all the participants, 51.15% (4 741) were afraid of being infected with HBV when getting on with hepatitis B patients or carriers; 51.29% (4 754), 61.14% (5 667) and 52.22% (4 841) of them were not willing to accept gifts from hepatitis B patients or carriers, have dinner with them, or hug and shake hands with them, respectively; 73.92% (6 852) were unwilling to their children's playing with kids whose parents were hepatitis B patients or carriers, and 86.68% (8 034) were unwilling to their children's marrying hepatitis B patients or carriers. Of all the participants, only 0.88% (82) were totally discrimination-free (discrimination score = 0); mild or without discrimination (< 0 discrimination score ≤ 5) accounted for 23.70% (2 197/9 269); severe discrimination (discrimination score ≥ 6) accounted for 76.30% (7 072). The multiple multinomial logistic regression showed that migratory workers, other occupations like technician, civil servants and village doctors were less likely to show severe HBV-related discrimination compared with farmers, with OR (95% CI) 0.86 (0.75-0.98), 0.77 (0.67-0.87), 0.57 (0.41-0.79), respectively. Compared with the lowest income group (< 10 000 RMB/year per person), and the highest income group (> 40 000 RMB/year per person) had an OR (95% CI) of 0.57 (0.46-0.70). People with higher education tended to show less severe discrimination. The high education group had an OR (95% CI) of 0.64 (0.51-0.80) based on the low education group. And compared with people whose self-assessment of health status was very good, those who assessed their health status as very poor showed less severe discrimination, with an OR (95% CI) of 0.41 (0.25-0.67).

CONCLUSIONThe situation of discrimination against hepatitis B patients and carriers among rural adults in three eastern provinces was serious. It is of great urgency to eliminate the discrimination. Work on eliminating hepatitis B discrimination should focus on farmers, people with low incomes, and people with low educational level.