Experiences and perceptions of HIV/AIDS-related stigma amongst people on antiretroviral treatment in Khayelitsha, South Africa

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University of Cape Town

HIV/AIDS-related stigma is a recognised problem for people living with HIV/AIDS (PLWHA) yet little research on experiences of stigma has been conducted in sub-Saharan Africa, the epicentre of the disease.? This paper employs quantitative analysis to measure the extent and nature of stigma experienced by 242 people on antiretroviral treatment in Khayelitsha (an urban African community in Cape Town, South Africa). This research draws an important distinction between experienced stigma and perceived stigma (i.e. perceptions of stigma in the community). The results show that while relatively few respondents (17%) reported experiencing a lot of stigma, the majority (75%) had experienced some stigma. Experiences of stigma within households were found to be rare (thus adding to the emerging evidence of general support for PLWHA from family members). Although some reported no experiences of stigma, almost all individuals reported perceived stigma (i.e. believed they lived in a stigmatising environment). Both experienced stigma and perceived stigma were related to inconsistent condom use, fear of disclosure, depression/anxiety and lack of self-efficacy/confidence. As expected, experienced stigma influenced perceived stigma and those affiliated to a religious organisation were shown to manifest more perceived stigma.? Health-related problems and the clinic where treatment was obtained (which could be a proxy for different social contexts) were significant determinants of experienced stigma. This indicates the importance of the biophysical manifestations of HIV/AIDS and community-level variables in shaping PLWHA's experiences and fears of stigma.