Self-stigma reduction among people living with HIV in healthcare facilities

Abstract

This retrospective pre-post intervention study examined the effects of a self-stigma reduction intervention among people living with HIV (PLHIV) in 11 model healthcare facilities between 2022 and 2024. The study examined outcomes related to stigma and discrimination, negative automatic thoughts, coping strategies, social support and positive self-perception. Data from 508 participants were collected using the HIV Stigma and Discrimination Survey among PLHIV, and qualitative data were drawn from supervisory reports and learning exchange activities conducted by the Division of AIDS and STIs. Quantitative data were analyzed using frequency, percentage, mean, standard deviation, and the paired t-test, while qualitative data were analyzed through categorization, interpretation, and thematic synthesis. The results showed that, after participating in the activities, the prevalence of self-stigma decreased to 25.4%. The proportion of participants reporting a very high level of self-worth increased from 26.8% to 61.8%. Mean scores before and after the intervention showed statistically significant differences (p<0.05). The intervention enhanced participants’ knowledge, understanding, and attitudes toward the causes and contributing factors of stigma and discrimination. It also promoted positive self-perception, constructive problem-solving skills, and the appropriate use of personal and social support. Therefore, healthcare facilities should regularly assess self-stigma levels among PLHIV and continuously implement stigma-reduction activities integrated into routine services, such as individual or group counseling and home visits while maintaining patient confidentiality. These activities should be aligned with mental health and social care programs, alongside community education initiatives to improve attitudes and foster inclusive, non-discriminatory environments for people living with HIV.