The authors used focus groups to identify and discuss the effect of HIV-related stigma on a number of issues related to prevention and treatment, including using PreP, getting tested regularly, and disclosing HIV status to their own communities and health care professionals. Focus groups were carried out in four states in the “Deep South”, and included over fifty participants who were identified as part of a “high-risk” population. The authors conclude that HIV-related stigma is ever-present in the lives of participants and creates negative feelings of fear and self-loathing. Participants cited faith communities as particular sites of distress, and emphasized that knowledge about HIV in the Deep South lags far behind modern scientific knowledge about HIV as a manageable, chronic disease.
Community level HIV-related stigma creates barriers being which are difficult to overcome – most study participants were disinclined to connect to competent care for fear of being associated with HIV and many expressed reluctance to get tested for HIV at all. Community support is key to the health and well-being of an individual, and people who are living with HIV or considered high-risk for contracting HIV are particularly vulnerable without it. Further, the pervasiveness of stigma among their communities (family, friends, church) makes people unwilling or unable disclose their HIV status. This silence perpetuates long-standing, fear-based myths about HIV and further makes people vulnerable to prosecution under many HIV criminal laws.