Official websites use. Share sensitive information only on official, secure websites. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Interviews and focus group discussions were audio-recorded, transcribed, translated to English, and analysed using a grounded theory approach.
However, HIV elicited feelings of guilt and shame as a sexually transmitted disease. Participants feared transmitting HIV to others and felt responsible for avoiding transmission. Many participants fearedβor had previously experiencedβrejection by partners due to their HIV status and reported hiding their medication, avoiding disclosure, or avoiding relationships altogether. As Susan Sontag wrote, AIDS diagnosis became a metaphor for indulgence, deviance, and transgression, a stigma or a mark of personal failure [ 1 ].
In sub-Saharan Africa SSA , different metaphors emerged based on epidemiological and cultural contexts. AIDS was linked to sex work, witchcraft, divine punishment for sinful acts, and attributed to immorality [ 2 β 7 ]. The negative social meaning associated with HIV was rooted in real fears of early death, leaving loved ones behind, and contagion.
Stigma, however, has been profoundly injurious to the mental health of PLHIV and has discouraged HIV testing, status disclosure, and treatment and prevention uptake [ 8 β 14 ]. South Africa rolled out ART in the public sector in , and approximately 5. However, studies have found that HIV remains a stigmatized condition [ 22 β 24 ]. The larger project aims to determine whether informing patients about HIV treatment-as-prevention during HIV post-test and adherence counselling affects their knowledge and attitudes; stigma and wellbeing; as well as towards ART uptake and adherence.
Data was collected in May The study followed guidelines for the conduct and reporting of qualitative studies S1 Text. Potential participants were identified and referred by lay HIV counsellors. Dedicated study staff with training and experience in qualitative interviews conducted all screening, consent procedures, and data collection. Interviews were conducted using an IDI guide S2 Text , lasted approximately 45 minutes, and were conducted in a private space within the clinic.
