HIV discourse on Reddit in the middle East and North Africa 2008 to 2025 exploratory analysis of topics and emotional tone

People living with HIV in the Middle East and North Africa face persistent stigma, and digital platforms may provide a window into how this stigma is expressed and contested. We examined longitudinal patterns and themes of HIV-related discourse on Reddit in the Middle East and North Africa (MENA). In this study, stigma was operationalized as language expressing moral judgment, blame, dehumanization, social exclusion, or discrimination toward people living with HIV or at-risk groups. We retrieved 1,682 posts and comments using Reddit and subreddit searches covering 2008 to 2025 across 67 country-linked and general Arabic subreddits. We applied a two-stage relevance filter and then manually annotated the highly relevant subset (n = 227) using a structured framework that captured topic, emotional tone, and attitude toward people living with HIV. Joinpoint regression identified an inflection in 2019 Q4, followed by an average 13.1% annual percent increase after 2020. The most common topics were stigma and discrimination (18.5%), testing (17.2%), and general knowledge (15.0%), with fear or anxiety being the most frequent emotional tone (31.2%). Egypt and Lebanon showed sustained increases, while Sudan showed a marked decline after 2025 Q1, which may reflect changes in platform access or visibility rather than a true absence of discourse. HIV-related discourse on Reddit in MENA increased after 2020 and was dominated by stigma, testing, and misinformation concerns. These exploratory findings may help inform culturally sensitive digital health communication and stigma-reduction efforts, while acknowledging that Reddit users are not representative of the broader population.