Curtis Marguerite, Nunez Alyson, Wong Milagros, Chenneville Tiffany, Gabbidon Kemesha, MacNeill Trixie, Errea Renato A, Galea Jerome T, Franke Molly F, Kosyluk Kristin A
Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Socios En Salud Sucursal Peru, Lima, Peru.
medRxiv. 2025 Jul 17:2025.07.10.25331213. doi: 10.1101/2025.07.10.25331213.
Human Immunodeficiency Virus (HIV) stigma constitutes a major barrier to HIV prevention, testing, and treatment, and is associated with harmful consequences for people living with HIV such as discrimination, rejection from family and friends, and treatment nonadherence. This study aimed to understand the drivers, perpetuators, and outcomes of HIV-related stigma among young people living with HIV (YPLWH) in Lima, Peru. From November 2022 to June 2023, we conducted interviews and focus groups with a diverse group of 75 YPWLH, in addition to healthcare providers and HIV advocates, to discuss their experiences of HIV-related stigma. Audio recordings were transcribed verbatim and analyzed for emergent themes using framework analysis. Participants identified the drivers of HIV-related stigma as a lack of information about HIV and misinformation about HIV, and the key power groups who perpetuate this stigma, which included parents and older generations, educators, and healthcare providers. Participants reported outcomes of HIV-related stigma; these included feelings of fear, shame, and loneliness, and enacted behaviors such as treatment nonadherence, nondisclosure of HIV diagnosis, and social avoidance. Participants also reported health outcomes of sickness, death, and HIV transmission, and social outcomes including discrimination from employers, educators, and peers, and loss of social support. These findings are critical to understanding how HIV-related stigma manifests in the cultural context of Lima, Peru, and can be used to inform effective interventions to reduce and mitigate the impacts of HIV-related stigma.
人类免疫缺陷病毒（HIV）污名是HIV预防、检测和治疗的主要障碍，并且与HIV感染者的有害后果相关，如歧视、被家人和朋友排斥以及治疗不依从。本研究旨在了解秘鲁利马的HIV感染者（YPLWH）中与HIV相关污名的驱动因素、持续存在因素及后果。2022年11月至2023年6月，我们除了与医疗服务提供者和HIV倡导者之外，还对75名不同的YPLWH进行了访谈和焦点小组讨论，以探讨他们与HIV相关污名的经历。对录音进行逐字转录，并使用框架分析法分析新出现的主题。参与者将与HIV相关污名的驱动因素确定为缺乏关于HIV的信息以及关于HIV的错误信息，以及使这种污名持续存在的关键权力群体，其中包括父母和老一辈、教育工作者以及医疗服务提供者。参与者报告了与HIV相关污名的后果；这些包括恐惧、羞耻和孤独感，以及出现的行为，如治疗不依从、不透露HIV诊断以及社交回避。参与者还报告了疾病、死亡和HIV传播等健康后果，以及包括来自雇主、教育工作者和同龄人歧视以及社会支持丧失等社会后果。这些发现对于理解在秘鲁利马的文化背景下与HIV相关污名如何表现至关重要，并且可用于为减少和减轻与HIV相关污名影响的有效干预措施提供信息。
