How Women Living with HIV (WLWH) Respond to and Manage HIV-Related Stigma Open Access

Fletcher, Michelle (Spring 2020)

Permanent URL:


Background. HIV-related stigma interventions for people living with HIV in the United States focus largely on coping, disclosure, social support, and adherence self-management skills. Women are disproportionately impacted by HIV-related and intersectional stigma. Few interventions focus on effective stigma response and management strategies currently used by women living with HIV (WLWH).

Objective. To understand how WLWH respond to and manage HIV-related stigma in order to inform intervention development.

Methods. Between June and December 2015, 76 qualitative interviews focusing on HIV-stigma were conducted among WLWH in San Francisco, CA, Atlanta, GA, Jackson, MS, and Birmingham, AL. Interviews were recorded, transcribed, and coded thematically to elucidate and categorize strategies for responding to stigma.

Results. We identified four strategies: (1) HIV education: women provided information about HIV transmission and living with HIV to family members, friends, and the community, to dispel misconceptions; (2) Selecting Relationships: women built relationships with people who provided non-judgmental, affirming support, and physically removed themselves from people they identified as negative, including those who perpetuate HIV-related stigma; (3) Resistance: women advocated for themselves or other WLWH by responding to experienced stigma with assertive language or behavior; and (4) Disclosure: some women avoided HIV-related stigma by choosing to not inform others of their HIV status.

Conclusion. Further research should examine the relative utility of these, and other strategies used by WLWH for responding to and managing HIV-stigma. These approaches to addressing stigma may be leveraged in stigma reduction interventions to achieve greater equity and better health outcomes for WLWH.  

Table of Contents

Table of Contents

Chapter 1: Review of Literature 1

Background and Significance of Stigma 1

Stigma and Health 1

Stigma Impact on Population Health 3

Stigma Impact on Women Living with HIV (WLWH) 3

Approaches to Addressing HIV-Related Stigma 4

Existing Stigma Interventions for WLWH 5

Importance of Stigma Management 6

Problem Statement 7

Purpose Statement 8

Chapter 2: Manuscript 9

Student Contribution 10

Abstract 11

Introduction 12

Methods 15

Study Population 15

Sampling and Recruitment Strategies 15

Data Collection 16

Data Analysis 16

Ethics Statement 16

Results 16

Participant Characteristics 17

HIV-Related Education 17

Selecting Relationships 19

Resistance 20

Disclosure 22

Discussion 23

Chapter 3: Conclusions and Recommendations 26

References 28

About this Master's Thesis

Rights statement
  • Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.
  • English
Research Field
Committee Chair / Thesis Advisor
Committee Members
Last modified

Primary PDF

Supplemental Files