Drivers, Facilitators, and Impacts of Stigma Among Youth Living with HIV in Lima, Peru

Abstract

Human Immunodeficiency Virus (HIV) stigma constitutes a major barrier to HIV prevention, testing, and treatment, and is associated with harmful consequences for people living with HIV such as discrimination, rejection from family and friends, and treatment nonadherence. This study aimed to understand the drivers, perpetuators, and outcomes of HIV-related stigma among young people living with HIV (YPLWH) in Lima, Peru. From November 2022 to June 2023, we conducted interviews and focus groups with a diverse group of 75 YPWLH, in addition to healthcare providers and HIV advocates, to discuss their experiences of HIV-related stigma. Audio recordings were transcribed verbatim and analyzed for emergent themes using framework analysis. Participants identified the drivers of HIV-related stigma as a lack of information about HIV and misinformation about HIV, and the key power groups who perpetuate this stigma, which included parents and older generations, educators, and healthcare providers. Participants reported outcomes of HIV-related stigma; these included feelings of fear, shame, and loneliness, and enacted behaviors such as treatment nonadherence, nondisclosure of HIV diagnosis, and social avoidance. Participants also reported health outcomes of sickness, death, and HIV transmission, and social outcomes including discrimination from employers, educators, and peers, and loss of social support. These findings are critical to understanding how HIV-related stigma manifests in the cultural context of Lima, Peru, and can be used to inform effective interventions to reduce and mitigate the impacts of HIV-related stigma.

Keywords: adolescents; discrimination; men who have sex with men; transgender women; youth.

Figure 1.. Moderation of stigma

Figure 2.. Outcomes of Stigma among PLWH