Institutional stigma toward people affected by tuberculosis in primary health care facilities in a district of Lima, Peru

Contreras-Cerdeña E.J.; Torres-Obregón D.; Gianella-Malca C.; Patiño-Rabines P.; Pesantes M.A. · Salud Colectiva (2026) · DOI: 10.18294/sc.2026.6140

Resumen

Despite biomedical advances in the diagnosis and treatment of tuberculosis, the institutional reproduction of stigma as a therapeutic barrier to treatment remains a persistent challenge. This article examines how institutional stigma toward people affected by tuberculosis is reproduced in primary health care facilities in San Juan de Lurigancho, Lima, Peru. Using a qualitative approach, the study combined semi-structured interviews with 16 health workers across six primary health care centers, non-participant observation of tuberculosis care settings in three health centers, and spatial analysis of all six centers, conducted between February and December 2025. The findings show that stigma is materialized through three interconnected mechanisms: health facility architecture that structurally undermines confidentiality through segregated patient pathways and visible signage; epidemiological surveillance technologies that produce the forced visibility of the diagnosis; and conditions of institutional overload that constrain the provision of comprehensive care. The article argues that improving treatment adherence requires interventions not only in the processes of the social determination of health but also in the institutional arrangements that produce and reproduce stigmatization. © (2026), (Universidad Nacional de Lanos). All rights reserved.

Instituciones: Pontificia Universidad Católica del Perú