IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v22y2025i7p1011-d1688287.html
   My bibliography  Save this article

Intersectional Barriers Among PLHIV in Rural Illinois: Insights from a Pilot QCA Study

Author

Listed:
  • John Matta

    (School of Engineering, Southern Illinois University Edwardsville, Edwardsville, IL 62025, USA)

Abstract

People living with HIV (PLHIV) in under-resourced rural regions face intersecting social and structural barriers that intensify their vulnerability. This pilot study explored how overlapping marginalized identities and socioeconomic hardship shape experiences of discrimination among PLHIV in Southern Illinois. Twenty-two participants completed a community-informed survey that captured racial, sexual, and gender identities alongside indicators of stigma across healthcare, housing, employment, and community settings. The findings reveal that most participants experienced at least one form of discrimination, with the highest burden concentrated among those identifying as Black, Nonbinary, Gay/Lesbian, or low-income. Discrimination was particularly prevalent in healthcare and housing environments. Importantly, poverty and housing instability were not just common but appeared to amplify the experience of stigma, compounding the effects of identity-based marginalization. These results highlight the urgent need for integrated, affirming, and structurally responsive interventions tailored to the realities of multiply marginalized PLHIV in rural areas. Future research and services must consider the interplay of identity and economic precarity in order to promote equitable care and support.

Suggested Citation

  • 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.
  • Handle: RePEc:gam:jijerp:v:22:y:2025:i:7:p:1011-:d:1688287
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/22/7/1011/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/22/7/1011/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Metzl, Jonathan M. & Hansen, Helena, 2014. "Structural competency: Theorizing a new medical engagement with stigma and inequality," Social Science & Medicine, Elsevier, vol. 103(C), pages 126-133.
    2. John Matta & Virender Singh & Trevor Auten & Prashant Sanjel, 2023. "Inferred networks, machine learning, and health data," PLOS ONE, Public Library of Science, vol. 18(1), pages 1-20, January.
    3. repec:aph:ajpbhl:10.2105/ajph.2017.303744_4 is not listed on IDEAS
    4. Bowleg, L., 2012. "The problem with the phrase women and minorities: Intersectionality-an important theoretical framework for public health," American Journal of Public Health, American Public Health Association, vol. 102(7), pages 1267-1273.
    5. Turan, B. & Hatcher, A.M. & Weiser, S.D. & Johnson, M.O. & Rice, W.S. & Turan, J.M., 2017. "Framing mechanisms linking HIV-related stigma, adherence to treatment, and health outcomes," American Journal of Public Health, American Public Health Association, vol. 107(6), pages 863-869.
    6. Colleen McLuckie & Mai T. Pho & Kaitlin Ellis & Livia Navon & Kelly Walblay & Wiley D. Jenkins & Christofer Rodriguez & Marynia A. Kolak & Yen-Tyng Chen & John A. Schneider & Whitney E. Zahnd, 2019. "Identifying Areas with Disproportionate Local Health Department Services Relative to Opioid Overdose, HIV and Hepatitis C Diagnosis Rates: A Study of Rural Illinois," IJERPH, MDPI, vol. 16(6), pages 1-14, March.
    7. 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.
    8. Ramirez-Valles, J. & Garcia, D. & Campbell, R.T. & Diaz, R.M. & Heckathorn, D.D., 2008. "HIV infection, sexual risk behavior, and substance use among Latino gay and bisexual men and transgender persons," American Journal of Public Health, American Public Health Association, vol. 98(6), pages 1036-1042.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Courtney Caiola & Marianne R. Choufani & Juliette André & Sadie B. Sommer & Alexander M. Schoemann & Sarah B. Bass & Julie Barroso, 2024. "Social Location and Decision-Making Among Women Living with HIV in the Southern United States: An Intersectional Approach," IJERPH, MDPI, vol. 21(12), pages 1-16, November.
    2. 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.
    3. Matshabane, Olivia P. & Campbell, Megan M. & Faure, Marlyn C. & Appelbaum, Paul S. & Marshall, Patricia A. & Stein, Dan J. & de Vries, Jantina, 2021. "The role of causal knowledge in stigma considerations in African genomics research: Views of South African Xhosa people," Social Science & Medicine, Elsevier, vol. 277(C).
    4. Whittle, Henry J. & Leddy, Anna M. & Shieh, Jacqueline & Tien, Phyllis C. & Ofotokun, Ighovwerha & Adimora, Adaora A. & Turan, Janet M. & Frongillo, Edward A. & Turan, Bulent & Weiser, Sheri D., 2020. "Precarity and health: Theorizing the intersection of multiple material-need insecurities, stigma, and illness among women in the United States," Social Science & Medicine, Elsevier, vol. 245(C).
    5. Goodman, Ashley & Fleming, Kim & Markwick, Nicole & Morrison, Tracey & Lagimodiere, Louise & Kerr, Thomas, 2017. "“They treated me like crap and I know it was because I was Native”: The healthcare experiences of Aboriginal peoples living in Vancouver's inner city," Social Science & Medicine, Elsevier, vol. 178(C), pages 87-94.
    6. Lin, Qinyun & Kolak, Marynia & Watts, Beth & Anselin, Luc & Pollack, Harold & Schneider, John & Taylor, Bruce, 2022. "Individual, interpersonal, and neighborhood measures associated with opioid use stigma: Evidence from a nationally representative survey," Social Science & Medicine, Elsevier, vol. 305(C).
    7. Abrams, Jasmine A. & Tabaac, Ariella & Jung, Sarah & Else-Quest, Nicole M., 2020. "Considerations for employing intersectionality in qualitative health research," Social Science & Medicine, Elsevier, vol. 258(C).
    8. Logie, Carmen H. & Williams, Charmaine C. & Wang, Ying & Marcus, Natania & Kazemi, Mina & Cioppa, Lynne & Kaida, Angela & Webster, Kath & Beaver, Kerrigan & de Pokomandy, Alexandra & Loutfy, Mona, 2019. "Adapting stigma mechanism frameworks to explore complex pathways between intersectional stigma and HIV-related health outcomes among women living with HIV in Canada," Social Science & Medicine, Elsevier, vol. 232(C), pages 129-138.
    9. 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.
    10. Daniel Demant & Oscar Oviedo-Trespalacios & Julie-Anne Carroll & Jason A. Ferris & Larissa Maier & Monica J. Barratt & Adam R. Winstock, 2018. "Do people with intersecting identities report more high-risk alcohol use and lifetime substance use?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(5), pages 621-630, June.
    11. Victor C Matos & Thiago S Torres & Paula M Luz, 2024. "Adherence to antiretroviral therapy among cisgender gay, bisexual and other men who have sex with men in Brazil: Evaluating the role of HIV-related stigma dimensions," PLOS ONE, Public Library of Science, vol. 19(8), pages 1-20, August.
    12. Theo Beltran & Amani M. Allen & Jess Lin & Caitlin Turner & Emily J. Ozer & Erin C. Wilson, 2019. "Intersectional Discrimination Is Associated with Housing Instability among Trans Women Living in the San Francisco Bay Area," IJERPH, MDPI, vol. 16(22), pages 1-11, November.
    13. Rathert, Cheryl & Mittler, Jessica N. & Vogus, Timothy J. & Lee, Yuna S.H., 2023. "Better outcomes through patient – Provider therapeutic connections? An exploratory study of proposed mediating variables," Social Science & Medicine, Elsevier, vol. 338(C).
    14. Alvarez, Camila H. & Evans, Clare Rosenfeld, 2021. "Intersectional environmental justice and population health inequalities: A novel approach," Social Science & Medicine, Elsevier, vol. 269(C).
    15. Silvia Loi & Peng Li & Mikko Myrskylä, 2022. "At the intersection of adverse life course pathways: the effects on health by nativity," MPIDR Working Papers WP-2022-018, Max Planck Institute for Demographic Research, Rostock, Germany.
    16. Metheny, Nicholas & Dusing, Gabriel John & Ndagurwa, Pedzisai & Mkhize, Sthembiso Pollen, 2025. "Disparities in quality of life by race, gender, and sexual orientation: An intersectional analysis of population-representative data in Gauteng, South Africa," Social Science & Medicine, Elsevier, vol. 366(C).
    17. Mooney, Shelagh, 2018. "Illuminating intersectionality for tourism researchers," Annals of Tourism Research, Elsevier, vol. 72(C), pages 175-176.
    18. Layland, Eric K. & Maggs, Jennifer L. & Kipke, Michele D. & Bray, Bethany C., 2022. "Intersecting racism and homonegativism among sexual minority men of color: Latent class analysis of multidimensional stigma with subgroup differences in health and sociostructural burdens," Social Science & Medicine, Elsevier, vol. 293(C).
    19. Montenegro, Roberto E. & Dori-Hacohen, Gonen, 2020. "Morality in sugar talk: Presenting blood glucose levels in routine diabetes medical visits," Social Science & Medicine, Elsevier, vol. 253(C).
    20. Warren Kealy-Bateman & Georgina M. Gorman & Adam P. Carroll, 2021. "Patient/Consumer Codesign and Coproduction of Medical Curricula: A Possible Path Toward Improved Cultural Competence and Reduced Health Disparity," SAGE Open, , vol. 11(2), pages 21582440211, June.

    More about this item

    Keywords

    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:22:y:2025:i:7:p:1011-:d:1688287. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.