The effect of affiliate stigma on individuals affected by stigmatised conditions: A scoping review.

Affiliate stigma occurs when a close acquaintance (e.g., family member, friend, or caregiver) of a Person with a Stigmatising Condition (PwSC) internalises and accepts society's stigmatising beliefs about them due to their association with the stigmatised individual. In turn, affiliate stigma may shape how the acquaintance (i.e., the ‘affiliate’) supports or engages with the PwSC, which may alter the quality or extent of support received by the PwSC. In this scoping review, we examined how affiliate stigma affects PwSCs. A scoping review was conducted following PRISMA guidelines. A comprehensive electronic search of databases, including MEDLINE (via PubMed), S.C.O.P.U.S., Web of Science, and PsycINFO revealed 2528 unique studies. The search was limited to studies published in English from the inception of each database to August 2024. After abstract and full-text screening, 27 articles met the inclusion criteria. None of the studies directly measured the impact of affiliate stigma on PwSC’s health and wellbeing; instead, the impact was inferred from the data. Nevertheless, an association between affiliate stigma and negative support systems for PwSCs was noted in most studies. These associations were classified into five themes: 1) Ways of caring for the PwSC, 2) Opportunities for social interaction and activity engagement, 3) Behavioural and mental health difficulties in the PwSC, 4) Engagement with healthcare services, and 5) Family dynamics. The results of this review underscore the need for further exploration of these associations, particularly within specific socio-cultural contexts, to inform the development of comprehensive support systems for both PwSCs and their affiliates.