Strategies that women living with HIV use to respond to and manage HIV-related stigma: a qualitative study

HIV-related stigma can adversely affect the mental and physical health of women living with HIV (WLWH) by contributing to increased levels of depression, anxiety, and social isolation, which may also exacerbate other types of health disparities experienced by WLWH. Some women manage to successfully cope with HIV-related stigma, potentially mitigating its health consequences. This study sought to investigate HIV-related stigma management strategies employed by WLWH. Seventy-six qualitative interviews were conducted among WLWH, recruited from four Women’s Interagency HIV Study sites. Data were analyzed using thematic coding. We identified four stigma management strategies: (1) Teaching others about HIV : sharing information about HIV transmission and personal experiences of living with HIV to dispel misconceptions and reduce stigma; (2) Self-defense practices : actions taken by WLWH to defend themselves from the harmful effects of HIV-related stigma; (3) Withholding HIV status : deliberately withholding one’s HIV status from others to avoid HIV-related stigma and the potential negative consequences of disclosure; and (4) Social isolation : intentional withdrawal from close social interactions and relationships due to fear of HIV-related stigma, discrimination, and rejection. The identified management strategies highlight efforts WLWH utilize to navigate and mitigate HIV-related stigma. These findings suggest that enhancing HIV education in addition to efforts to reduce stigma in society could be key components in future anticipated and internalized stigma reduction interventions. Further research should examine the utility of these strategies and how they may be integrated into interventions to support WLWH in coping with stigma and improving their overall well-being.