HIV-Related Stigma and Discrimination in Thailand: Findings from the People Living with HIV Stigma Index 2.0

Background: HIV-related stigma and discrimination remain barriers to equitable HIV prevention, treatment, and well-being in Thailand despite their longstanding inclusion in the national HIV response. This study examined contemporary experiences of stigma and discrimination among people living with HIV. Methods: The people living with HIV Stigma Index 2.0 was a community-led mixed-methods study conducted from August 2022 to January 2023. The quantitative survey enrolled 2508 people living with HIV from 24 provinces covering all 13 health regions, including general adults living with HIV, four key population groups, migrant workers, and young people. A nested qualitative study included 174 in-depth interviews across six population groups. Results: Sixteen percent of participants reported HIV-related discrimination in healthcare services in the previous 12 months, 4.7% reported community stigma in the past 12 months, 39.0% reported internalized stigma, and 2.7% experienced rights abuse in the past 12 months. Younger people living with HIV reported significantly higher levels of healthcare discrimination, community stigma, internalized stigma, and rights abuse than older participants and the general people living with HIV reference group. Compared with general people living with HIV, sex workers and people who use drugs reported significantly higher levels of community stigma; men who have sex with men, sex workers, people who use drugs, and migrant workers reported significantly higher internalized stigma; and transgender people and sex workers reported significantly higher levels of rights abuse. Qualitative findings highlighted anticipated and enacted stigma, confidentiality concerns, internalized stigma, intersecting identities, rights violations, and resilience. Conclusions: HIV-related stigma remains evident in healthcare, community, and personal domains. Younger people living with HIV and key populations were particularly vulnerable to HIV-related stigma, discrimination, and rights abuse. Responses should combine updated public communication, stigma-free and person-centered healthcare, protection of privacy and rights, support for internalized stigma and mental well-being, and sustained leadership of people living with HIV.