Understanding the Intersecting Roles of Culture, Misinformation, and Socioecological Systems on HIV Stigma and Coping

HIV/AIDS-related stigma is a persistent and pernicious problem that profoundly impacts the HIV treatment cascade and adversely affects HIV prevention and treatment at both societal and individual levels. We utilized an interpretive phenomenological approach to conceptualize the study and collected data through six focus groups (N = 31) with youths ages 18 to 25 from an urban HIV clinic in Kampala. The data were transcribed verbatim, and five major themes were identified. These themes reflect a complex web of stigma facilitators and reinforcers, intersecting stigma manifestations, leading to poor health outcomes and coping strategies. The study participants reported experiencing stigma and discrimination at every level of the ecological system, which was reinforced by a lack of awareness and misinformation about HIV. Community-based and interpersonal stigma were directly felt by the participants and internalized, resulting in physical and mental health challenges related to substance use and medication adherence. Interventions involving social workers to address HIV stigma across various intersections of the ecological system are recommended to mitigate stigmatization and assist in positive coping for better HIV health outcomes and welfare.