Affiliate stigma and associated factors among informal caregivers of people with mental illness in southwestern Uganda: A multi-center cross-sectional study

The stigma surrounding mental illnesses is widespread and informal caregivers of patients with mental illness face stigma because of their relationship with the patients they care for. Despite the key role played by these informal caregivers in the management of people with mental illness, few studies have assessed affiliate stigma and its factors associated among this population. This study aimed to investigate the prevalence of affiliate stigma and associated factors among caregivers of patients with mental illness in southwestern Uganda. We used a cross-sectional study design and enrolled 385 caregivers. We assessed affiliate stigma, depression, and social support using the affiliate stigma scale, patient health questionnaire-9 and social support using the social provision scale respectively. We ran multivariable logistic regression models to assess for the factors associated with affiliate stigma among caregivers. The prevalences of affiliate stigma and depression were 65.97% and 25.2% respectively. Factors associated with affiliate stigma included caregiving for one year or longer (AOR: 1.89; 95% CI: 01.07-03.35; p = 0.03), having more than one patient to care for (AOR: 3.40; 95% CI: 01.39-08.36; p = 0.01), being the only caregiver to the patient (AOR: 2.60; 95% CI: 1.27-5.33; p = 0.01), being depressed (AOR: 75.76; 95% CI: 10.03-572.26; p < 0.001), and social support (AOR: 0.14; 95% CI: 0.06-0.29; p = 0.04). This prevalence of affiliate stigma among caregivers of patients with mental illness is high in southwestern Uganda and depression is a key predictor. Considering the important role played by informal caregivers, more studies are necessary to inform interventions to address affiliate stigma, depression, and overall mental health of caregivers.