Addressing HIV stigma in healthcare settings in Ireland: Lessons learned from a collaborative study

Immense progress has been made in the treatment of HIV in recent years. People living with HIV now have life-spans close to par with HIV negative individuals, and do not transmit the virus once patients have reached the treatment goal of viral undetectablity, commonly referred to as undetectable equals untransmittable or U=U. Despite these advances, HIV-related stigma remains an on-going issue that affects the lives and well-being of many people living with HIV. There is clear evidence that experiences of HIV stigma in healthcare settings have adverse impacts both for the health and well-being of people living with HIV and population health. People living with HIV who experience stigma in healthcare settings often have difficulty trusting healthcare providers, and this can result in health avoiding behaviours. As a consequence, some may put off appointments, delay seeking care, or have poor engagement and retention in care. Such behaviours have obvious knockon effects for the health of the patient. Indeed there is evidence also that experiences of stigma in healthcare settings are linked to poor adherence to anti-retroviral medication (ARVs) and viral non-suppression. Apart from physical health outcomes, Stigma can also affect the mental health.

While stigma can lead to worse health outcomes on an individual level, the barrier to testing, treatment and care caused by stigmatising behaviours, also