Stigma of hearing loss and the use of hearing aids among adults with hearing loss: a cross-sectional study

Objectives This study explored stigma associated with hearing loss and hearing aid use among adults in Saudi Arabia. It examined the prevalence of hearing loss stigma (HLS) and hearing aid stigma (HAsS) and their associations with hearing aid use and selected demographic characteristics. Methods A cross-sectional survey was conducted among 403 adults with self-reported hearing loss. Participants completed an online questionnaire, distributed through convenience sampling, that included validated instruments assessing HLS, HAsS, and personal distress/inadequacy related to hearing loss. Results High levels of HLS and HAsS were reported by 50.12% and 82.93% of participants, respectively. Higher HLS levels were significantly associated with hearing aid use, lower educational attainments, unmarried status, lower incomes, greater self-reported hearing loss severity, and a longer duration of hearing loss. Notably, older individuals with lower incomes reported the highest levels of stigma. Among participants medically indicated for hearing aids, higher HAsS was associated with lower odds of hearing aid use, whereas higher HLS was associated with greater odds of use after adjustment for other model covariates. HLS was also strongly associated with personal distress and inadequacy. Conclusions High levels of HLS and HAsS were observed within the study sample, highlighting stigma as a prominent psychosocial concern. HLS and HAsS showed different associations with hearing aid use, with higher HAsS associated with lower odds of use and higher HLS associated with greater odds of use. These findings highlight the potential importance of addressing stigma within hearing healthcare and support further investigation of approaches to address HL- and HA-related stigma in the Saudi context.