“I have many burdens”: experiences and perceptions of vulnerabilities, healthcare, and support among PLHIV in Sweden: a qualitative interview study

People living with human immunodeficiency virus (PLHIV) often navigate complex and vulnerable circumstances shaped by intersecting social identities that influence their experiences with human immunodeficiency virus (HIV) infection, healthcare, and support services. This qualitative study explored how PLHIV in Sweden perceive and experience healthcare and social support. It draws on 32 in-depth interviews conducted in 2019, 2021, and 2024 with participants aged 20-65 years. Three central themes were identified through thematic analysis. The first theme, "<i>Carrying Many Burdens: Multiple Vulnerabilities, Overlapping Conditions, and Socioeconomic Hardship",</i> how overlapping identities, health issues, and financial hardship compound vulnerability. Second, "<i>Varying Attitudes and Practices in Healthcare Settings",</i> reflect inconsistent and sometimes problematic encounters with healthcare systems. The third theme, "<i>Nongovernmental Organizations Support is Valuable but Limited",</i> emphasizes the importance of support while revealing its inadequacy in reaching everyone and meeting all needs. These findings highlight the multifaceted vulnerabilities faced by PLHIV in Sweden and point to significant gaps in both healthcare and social support systems. Addressing these challenges calls for coordinated efforts across the structural, institutional, and individual levels.