"For It [My Status] to Be Known by Everyone … It Is Not Good": Experiences of and Responses to Stigma and Discrimination Among People on HIV Treatment in Urban Zimbabwe

Abstract

HIV-related stigma and discrimination remain pervasive despite dramatic improvements in the availability and accessibility of antiretroviral therapy (ART). We examined the experiences of HIV stigma and discrimination and coping strategies among people living with HIV (PLHIV) in urban Zimbabwe in 2018. We conducted eight focus group discussions, stratified by age and gender (women and men 18-29 years, women and men >29), as part of a discrete choice experiment on HIV treatment models. HIV-related stigma emerged as a key theme, with participants expressing the desire to be seen as "normal." However, being mocked, constant reminders that they had HIV, negative comments about PLHIV and regular trips to health facilities made "normality" elusive. Participants coped by ignoring stigmatizing comments and behaviors, minimizing social interactions, carefully selecting allies for support, adhering to ART in order to stay (and appear) healthy, and temporarily stopping ART. Stigma-reduction interventions for PLHIV and communities are urgently needed.

Keywords: HIV disclosure; HIV-related stigma and discrimination; Zimbabwe; antiretroviral drugs; care and support; differentiated service delivery models.