Abstract
Background: The pervasiveness of HIV-related stigma and discrimination, and its consequences on HIV prevention and treatment, have been well documented. However, little is known about the lived experiences of HIV-related stigma and its effects among the general adult population living with HIV in rural African settings. This study set out to explore this knowledge gap. Methods: From April to June 2018, we conducted in-depth interviews with a convenience sample of 40 adults living with HIV aged 18–58 years in Kilifi, Kenya. A semi-structured interview guide was used to explore experiences of HIV-related stigma and its impact on these adults. A framework approach was used to analyze the data using NVIVO 11 software. Results: Participants reported experiences of HIV-related stigma in its various forms (anticipated, perceived, internalised, and enacted), as well as its effects on HIV treatment and social and personal spheres. The internalisation of stigma caused by enacted stigma impacted care-seeking behavior resulting in worse overall health. Anxiety and depression characterized by suicidal ideation were the results of internalised stigma. Anticipated stigma prompted HIV medication concealment, care-seeking in remote healthcare facilities, and care avoidance. Fewer social interactions and marital conflicts resulted from perceived stigma. Overall, HIV-related stigma resulted in partial and non-disclosure of HIV seropositivity and medication non-adherence. At a personal level, mental health issues and diminished sexual or marital prospects (for the unmarried) were reported. Conclusion: Despite high awareness of HIV and AIDS among the general population in Kenya, adults living with HIV in rural Kilifi still experience different forms of HIV-related stigma (including self-stigma) that result in a raft of social, personal, and HIV-treatment-related consequences. Our findings underscore the urgent need to reevaluate and adopt more effective strategies for implementing HIV-related anti-stigma programs at the community level. Addressing individual-level stigma will require the design of targeted interventions. To improve the lives of adults living with HIV in Kilifi, the effects of HIV-related stigma, particularly on HIV treatment, must be addressed.
| Original language | English |
|---|---|
| Article number | 1188446 |
| Pages (from-to) | 1-12 |
| Number of pages | 12 |
| Journal | Frontiers in public health |
| Volume | 11 |
| Early online date | 21 Jun 2023 |
| DOIs | |
| Publication status | Published - 2023 |
Bibliographical note
Publisher Copyright:Copyright © 2023 Wanjala, Nyongesa, Mapenzi, Luchters and Abubakar.
Funding
The authors thank all participants who voluntarily took the time to participate in this study. The authors also appreciate the health facility managers and staff at the HIV specialized clinic, Kilifi County Hospital, for their support during the data collection period. Lastly, The authors sincerely appreciate and acknowledge permission from the Director of Kenya Medical Research Institute (KEMRI) to publish this work. This work was supported by funding from the Medical Research Council (grant number MR/M025454/1) to AA. This award is jointly funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID concordant agreement. It is also part of the EDCTP2 program supported by the European Union.
| Funders | Funder number |
|---|---|
| Kilifi County Hospital | |
| European Commission | |
| Department for International Development, UK Government | |
| Kenya Medical Research Institute | |
| UK Research and Innovation | |
| Medical Research Council | MR/M025454/1 |
Keywords
- adults’
- HIV-infection
- HIV-related stigma
- in-depth interview(s)
- Kenya
- people living with HIV/AIDS
- qualitative inquiry