Matta John
School of Engineering, Southern Illinois University Edwardsville, Edwardsville, IL 62025, USA.
Int J Environ Res Public Health. 2025 Jun 26;22(7):1011. doi: 10.3390/ijerph22071011.
People living with HIV (PLHIV) in under-resourced rural regions face intersecting social and structural barriers that intensify their vulnerability. This pilot study explored how overlapping marginalized identities and socioeconomic hardship shape experiences of discrimination among PLHIV in Southern Illinois. Twenty-two participants completed a community-informed survey that captured racial, sexual, and gender identities alongside indicators of stigma across healthcare, housing, employment, and community settings. The findings reveal that most participants experienced at least one form of discrimination, with the highest burden concentrated among those identifying as Black, Nonbinary, Gay/Lesbian, or low-income. Discrimination was particularly prevalent in healthcare and housing environments. Importantly, poverty and housing instability were not just common but appeared to amplify the experience of stigma, compounding the effects of identity-based marginalization. These results highlight the urgent need for integrated, affirming, and structurally responsive interventions tailored to the realities of multiply marginalized PLHIV in rural areas. Future research and services must consider the interplay of identity and economic precarity in order to promote equitable care and support.
资源匮乏的农村地区的艾滋病毒感染者（PLHIV）面临着相互交织的社会和结构障碍，这些障碍加剧了他们的脆弱性。这项试点研究探讨了重叠的边缘化身份和社会经济困境如何塑造伊利诺伊州南部艾滋病毒感染者的歧视经历。22名参与者完成了一项基于社区的调查，该调查收集了种族、性取向和性别身份，以及医疗保健、住房、就业和社区环境中的耻辱感指标。研究结果显示，大多数参与者至少经历过一种形式的歧视，其中负担最重的集中在那些被认定为黑人、非二元性别、同性恋或低收入的人群中。歧视在医疗保健和住房环境中尤为普遍。重要的是，贫困和住房不稳定不仅常见，而且似乎加剧了耻辱感，使基于身份的边缘化影响更加复杂。这些结果凸显了迫切需要针对农村地区多重边缘化艾滋病毒感染者的现实情况，制定综合、肯定性且具有结构响应性的干预措施。未来的研究和服务必须考虑身份和经济不稳定之间的相互作用，以促进公平的护理和支持。
