A Qualitative Examination of Stigma Among Formerly Incarcerated Adults Living With HIV

Abstract

The over-representation of people with stigmatized characteristics in the U.S. criminal justice population, including adults living with HIV, makes formerly incarcerated adults susceptible to multiple stigmas. Yet, the experience of HIV-related stigma, especially among individuals who have an additional compromising status in society (i.e., a criminal record) is understudied. This study used qualitative data from 30 interviews with formerly incarcerated adults living with HIV to explore the contexts within which one of these statuses becomes more salient than another for these individuals. Anticipated stigma was the primary barrier to disclosure of either status. The salience of anticipated stigma depended on the context within which disclosure may occur, including social interactions, employment, and engaging in HIV care. Communities with a high prevalence of HIV and incarceration, and health care providers within those communities should be targeted for stigma reduction efforts. Practitioners should work to empower individuals living with HIV, especially in the face of multiple potential stigmas.

Physical, Emotional, and Psychosocial Challenges Associated with Daily Dosing of HIV Medications and Their Impact on Indicators of Quality of Life: Findings from the Positive Perspectives Study

“…Different socio-cognitive structures of stigma exist, including stereotypes, prejudices, and discrimination; these could be experienced by PLHIV as internalized, anticipated, or enacted stigma [ 12 – 14 ]. Stereotyping, where PLHIV are perceived to have certain stigmatizing attributes, can be particularly aggravating, especially if the individual does not identify with one or more of the stigmatized statuses [ 13 ]. To avoid discrimination, some may choose not to share their HIV status [ 15 , 16 ], especially if they have witnessed other PLHIV at the receiving end of stigma [ 13 ].…”

“…Stereotyping, where PLHIV are perceived to have certain stigmatizing attributes, can be particularly aggravating, especially if the individual does not identify with one or more of the stigmatized statuses [ 13 ]. To avoid discrimination, some may choose not to share their HIV status [ 15 , 16 ], especially if they have witnessed other PLHIV at the receiving end of stigma [ 13 ]. Unfortunately, this may come at the cost of receiving fragmented healthcare or failing to get needed social support from friends and family.…”

Multiple burdens of stigma for prisoners participating in opioid antagonist treatment (OAT) programmes in Indonesian prisons: a qualitative study

“…Intersectional stigma takes place when multiple identities co-occur and are linked together. When this happens the experience of stigma is often amplified, (Swan et al 2016) preventing people living with these conditions accessing both individual and structural support (Jackson-Best et al 2018). In this study injecting drug use and associated characteristics, HIV positive status, and participation in MMT programmes were linked in discussions of stigma and found to amplify the stigma experienced.…”

HIV-related stigma and uptake of antiretroviral treatment among incarcerated individuals living with HIV/AIDS in South African correctional settings: A mixed methods analysis

“…For expansion of delivery and uptake of HIV services, addressing known barriers, such as stigma, is necessary [11][12][13][14]. Individuals experience incarceration stigma which is further compounded by living with HIV [15][16][17]. As a result, they may experience enacted (overt acts of hostility and discrimination due to HIV status), perceived (anticipated discriminatory acts as a result of HIV status) or internalised (acceptance of negative beliefs and feelings about HIV) stigma [11].…”

“…As a result, they may experience enacted (overt acts of hostility and discrimination due to HIV status), perceived (anticipated discriminatory acts as a result of HIV status) or internalised (acceptance of negative beliefs and feelings about HIV) stigma [11]. The intersection of these types of stigma create barriers to engagement in HIV care services [17].…”