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Perceptions of intersectional stigma among diverse women living with HIV in the United States

Author

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  • Rice, Whitney S.
  • Logie, Carmen H.
  • Napoles, Tessa M.
  • Walcott, Melonie
  • Batchelder, Abigail W.
  • Kempf, Mirjam-Colette
  • Wingood, Gina M.
  • Konkle-Parker, Deborah J.
  • Turan, Bulent
  • Wilson, Tracey E.
  • Johnson, Mallory O.
  • Weiser, Sheri D.
  • Turan, Janet M.

Abstract

Attitudes and behavior that devalue individuals based upon their HIV status (HIV-related stigma) are barriers to HIV prevention, treatment, and wellbeing among women living with HIV. Other coexisting forms of stigma (e.g., racism, sexism) may worsen the effects of HIV-related stigma, and may contribute to persistent racial and gendered disparities in HIV prevention and treatment. Few studies examine perceptions of intersectional stigma among women living with HIV. From June to December 2015, we conducted 76 qualitative interviews with diverse women living with HIV from varied socioeconomic backgrounds enrolled in the Women's Interagency HIV Study (WIHS) in Birmingham, Alabama; Jackson, Mississippi; Atlanta, Georgia; and San Francisco, California. Interview guides facilitated discussions around stigma and discrimination involving multiple interrelated identities. Interviews were audio-recorded, transcribed verbatim, and coded using thematic analysis. Interviewees shared perceptions of various forms of stigma and discrimination, most commonly related to their gender, race, and income level, but also incarceration histories and weight. Women perceived these interrelated forms of social marginalization as coming from multiple sources: their communities, interpersonal interactions, and within systems and structures. Our findings highlight the complexity of social processes of marginalization, which profoundly shape life experiences, opportunities, and healthcare access and uptake among women living with HIV. This study highlights the need for public health strategies to consider community, interpersonal, and structural dimensions across intersecting, interdependent identities to promote the wellbeing among women living with HIV and to reduce social structural and health disparities.

Suggested Citation

  • Rice, Whitney S. & Logie, Carmen H. & Napoles, Tessa M. & Walcott, Melonie & Batchelder, Abigail W. & Kempf, Mirjam-Colette & Wingood, Gina M. & Konkle-Parker, Deborah J. & Turan, Bulent & Wilson, Tra, 2018. "Perceptions of intersectional stigma among diverse women living with HIV in the United States," Social Science & Medicine, Elsevier, vol. 208(C), pages 9-17.
  • Handle: RePEc:eee:socmed:v:208:y:2018:i:c:p:9-17
    DOI: 10.1016/j.socscimed.2018.05.001
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    References listed on IDEAS

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    8. Pudney, Ellen V. & Himmelstein, Mary S. & Puhl, Rebecca M. & Foster, Gary D., 2020. "Distressed or not distressed? A mixed methods examination of reactions to weight stigma and implications for emotional wellbeing and internalized weight bias," Social Science & Medicine, Elsevier, vol. 249(C).
    9. Lanthier, Stephanie & Mason, Robin & Logie, Carmen H. & Myers, Ted & Du Mont, Janice, 2023. "“Coming out of the closet about sexual assault”: Intersectional sexual assault stigma and (non) disclosure to formal support providers among survivors using Reddit," Social Science & Medicine, Elsevier, vol. 328(C).
    10. John Matta, 2025. "Intersectional Barriers Among PLHIV in Rural Illinois: Insights from a Pilot QCA Study," IJERPH, MDPI, vol. 22(7), pages 1-15, June.
    11. Norcini-Pala, Andrea & Stringer, Kristi L. & Kempf, Mirjam-Colette & Konkle-Parker, Deborah & Wilson, Tracey E. & Tien, Phyllis C. & Wingood, Gina & Neilands, Torsten B. & Johnson, Mallory O. & Weiser, 2025. "Longitudinal associations between intersectional stigmas, antiretroviral therapy adherence, and viral load among women living with HIV using multidimensional latent transition item response analysis," Social Science & Medicine, Elsevier, vol. 366(C).
    12. Ryan, Martha S. & Nambiar, Devaki & Ferguson, Laura, 2019. "Sex work-related stigma: Experiential, symbolic and structural forms in the health systems of Delhi, India," Social Science & Medicine, Elsevier, vol. 228(C), pages 85-92.
    13. Lunthita M. Duthely & Sanjana Satish & Sapna A. Kedia & Lilliana Vilchez & Priscilla T. Valls & Michaela E. Larson & Carolina Cruzval O’Reilly & Vanessa Hurtado & Maria Camila Bernal & Karla Inestroza, 2024. "What Women with HIV Know about Heart Health and Cardiovascular Risk and Intervention Preferences," IJERPH, MDPI, vol. 21(9), pages 1-11, August.
    14. Abbamonte, J.M. & Ramlagan, S. & Lee, T.K. & Cristofari, N.V. & Weiss, S.M. & Peltzer, K. & Sifunda, S. & Jones, D.L., 2020. "Stigma interdependence among pregnant HIV-infected couples in a cluster randomized controlled trial from rural South Africa," Social Science & Medicine, Elsevier, vol. 253(C).
    15. Quinn, Katherine & Bowleg, Lisa & Dickson-Gomez, Julia, 2019. "“The fear of being Black plus the fear of being gay”: The effects of intersectional stigma on PrEP use among young Black gay, bisexual, and other men who have sex with men," Social Science & Medicine, Elsevier, vol. 232(C), pages 86-93.
    16. Xin Pan & Maarten Loopmans, 2021. "Intersectional Heterotopia: HIV and LGBTQ+ Movement in China," Tijdschrift voor Economische en Sociale Geografie, Royal Dutch Geographical Society KNAG, vol. 112(2), pages 121-134, April.

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