Associations of Helicobacter pylori infection with stigma and the mediating roles of anxiety and depression: a combination of cross-sectional and cohort study

Background Stigma is common in certain infectious diseases and infection-related cancer. Helicobacter pylori (H. pylori) is infectious and related to gastric cancer. However, little is known about the relationship between H. pylori infection and stigma. Therefore, our study aims to investigate stigma and its influencing factors among patients with H. pylori infection. Materials and Methods 1144 participants were recruited from a tertiary hospital in northwest China from October 2023 to July 2024. The research instruments comprised Social Impact Scale, Gastrointestinal Systemic Response Score Scale, Hospital Anxiety and Depression Scale, Short Form Health Survey 12, General Self-efficacy Scale and Social Support Rating Scale. Multiple linear regression analysis was conducted to examine the relationship between H. pylori infection and stigma, as well as influencing factors of stigma in infected patients. Mediation models were used to evaluate whether anxiety and depression mediate the relationship between H. pylori infection and stigma. Results Compared to non-infected patients, those with H. pylori infection had higher total stigma scores (34 vs 27 points, P < 0.001) and a larger proportion of moderate-severe stigma (24.69% vs 9.81%, P < 0.001). H. pylori infection was positively correlated with stigma (β 5.38, 95%CI 3.83–6.94, p < 0.001), with anxiety symptom and depressive symptom mediating 13.37% and 9.90% of this correlation, respectively. In H. pylori-infection patients, age, seeking psychological help, receiving treatment and anxiety symptoms were positively correlated with stigma, while higher income, self-efficacy and quality of life were negatively correlated. Conclusion H. pylori-related stigma is common among infected patients. Therefore, routine stigma assessment, professional mental health support, counseling services, and public education are recommended to reduce stigma in this subpopulation.