Stigmatization and discrimination towards people living with HIV/AIDS attending antiretroviral clinic in a centre of excellence in HIV care in India

Trinath Sarkar, Nabarun Karmakar, Aparajita Dasgupta, Bibhuti Saha


Background: HIV/AIDS is a serious challenge globally. Plethora of morbidities due to crippling immune system reduces quality of life (QOL). The advent of HAART has changed this deadly disease to a chronic manageable illness with focus shifting from fighting virus to ensuring a good QOL. Objective of the study was to assess stigma and discrimination among PLHA and factors influencing, if any in Indian setting.

Methods: A cross sectional study was carried out among 220 male aged >15 years (PLHA) attending ART centre of centre of excellence in HIV care in India (CSTM, Kolkata) from May 2012-April 2013 using a pre-designed and pre-tested schedule regarding socio-demographic characteristics and social stigma. Statistical analysis was done using SPSS version 16.0 and p<0.05 was considered as significant.

Results: Nearly half (45%) and one-fifth (20.9%) of the study population were discriminated by the family and community respectively. Most (74.5%) of the study population had disclosed their HIV status to their family members. Maximum participants (96.4%) agreed that those who know their HIV status will tell that to others. In the multivariate model with increase in PCI the odds of score of dependant variable increases, so the odds of social stigma decrease (as increase in score means decrease in social stigma).

Conclusions: The results show that factors associated with stigma should be further explored as it’s important in considering public health interventions to improve care of PLHA in India.


Family, India, Male, Social stigma

Full Text:



Chambers LA, Rueda S, Baker DN, Wilson MG, Deutsch R, Raeifar E, et al. Stigma, HIV and health: a qualitative synthesis. BMC Public Health. 2015;15:848.

Wang K, Chen W, Zhang L, Bao M, Zhao H, Lu H. Facilitators of and barriers to HIV self-management: perspectives of HIV-positive women in China. Appl Nurs Res. 2016;32:91–7.

Kumar N, Unnikrishnan B, Thapar R, Mithra P, Kulkarni V, Holla R, et al. Stigmatization and Discrimination toward People Living with HIV/AIDS in a Coastal City of South India. J Int Association Providers AIDS Care. 2017;16(3):226–32.

Fekete E, Williams S, Skinta M. Internalised HIV-stigma, loneliness, depressive symptoms and sleep quality in people living with HIV. Psychol Health. 2017:1–18.

Burke SE, Calabrese SK, Dovidio JF, Levina OS, Uuskula A, Niccolai LM, et al. A tale of two cities: stigma and health outcomes among people with HIV who inject drugs in St. Petersburg, Russia and Kohtla-Jarve, Estonia. Soc Sci Med. 2015;130:154–61.

Shrestha R, Copenhaver M, Bazazi AR, Huedo-Medina TB, Krishnan A, Altice FL. A moderated mediation model of HIV-related stigma, depression, and social support on health-related quality of life among incarcerated Malaysian men with HIV and opioid dependence. AIDS Behav. 2017;21(4):1059–69.

Global Update on HIV Treatment 2013: Results, Impact and Opportunities, 2013. Available at Accessed 3 November 2018.

Huang Z, Fu Z, Zhao X, Qiu T, Zhao Y, Cao X, et al. Investigation on self-stigma and discrimination among HIV/AIDS patients in Suzhou. Jiangsu. J Prev Med. 2015;26(2):10–2.

Costelloe S, Kemppainen J, Brion J, MacKain S, Reid P, Frampton A, et al. Impact of anxiety and depressive symptoms on perceptions of stigma in persons living with HIV disease in rural versus urban North Carolina. AIDS Care. 2015;27(12):1425–8.

Ban Ki-Moon. The Stigma Factor: Biggest Hurdle To Combat Hiv/Aids. The Washington Times (Us). 2008.

Li H, Wei C, Tucker J, Kang D, Liao M, Holroyd E, et al. Barriers and facilitators of linkage to HIV care among HIV-infected young Chinese men who have sex with men: a qualitative study. BMC Health Serv Res. 2017;17(1):214.

Treves-Kagan S, Steward WT, Ntswane L, Haller R, Gilvydis JM, Gulati H, et al. Why increasing availability of ART is not enough: a rapid, community-based study on how HIV-related stigma impacts engagement to care in rural South Africa. BMC Public Health. 2016;16:87.

Brent RJ. The value of reducing HIV stigma. Soc Sci Med. 2016;151:233–40.

Fee E. The stigma of HIV. Am J Public Health. 2013;103(10):1747.

Nyblade L, MacQuarrie K. Can We Measure Hiv/Aids-Related Stigma and Discrimination? Current Knowledge About Quantifying Stigma In Developing Countries, 2006. Available at Accessed 06 November 2018.

Nebhinani N, Mattoo SK, Wanchu A. HIV Stigma and Specified Correlates in North India. Indian J Psychol Med. 2012;34(4);324-31.

Datta S, Bhattacherjee S, Sherpa PL, Banik S. Perceived HIV Related Stigma among Patients Attending ART Center of a Tertiary Care Center in Rural West Bengal, India. J Clin Diagnos Res. 2016;10(10):VC09-12.

Muralidharan S, Acharya AK, Margabandu S, Purushotaman S, Kannan R, Mahendrakar S, et al. Stigma and Discrimination faced by HIV-infected Adults on Antiretroviral Therapy for more than 1 Year in Raichur Taluk, Karnataka, India. J Contemporary Dental Practice. 2017;18(9):765-70.

Varas-Díaz N, Serrano-García I, Toro-Alfonso J, AIDS-Related Stigma and Social Interaction: Puerto Ricans Living With HIV/AIDS. Qual Health Res. 2005;15(2):169-87.

Mlobeli R. HIV/AIDS Stigma: An Investigation into the Perspectives and Experiences of People Living With HIV/AIDS, 2007. Available at: Accessed on 25 November 2018.

Cloete A, Simbayi LC, Kalichman SC , Strebel A, Henda N. Stigma and discrimination experiences of HIV-positive men who have sex with men in Cape Town, South Africa. AIDS Care. 2008;20(9):1105-10.

Stutterheim SE, Pryor JB, Bos AE, Hoogendijk R, Muris P, Schaalma HP. HIV-related stigma and psychological distress: the harmful effects of specific stigma manifestations in various social settings. AIDS. 2009;23(17):2353–7.

Bogart LM, Cowgill BO, Kennedy DP, Ryan G, Murphy DA, Elijah J, et al. HIV-Related Stigma among People with HIV and their Families: A Qualitative Analysis. AIDS and Behavior. 2008;12(2):244-54.

Rao D, Pryor JB, Gaddist BW, Mayer R. Stigma, Secrecy, and Discrimination: Ethnic/Racial Differences in the Concerns of People Living with HIV/AIDS. AIDS and Behavior. 2008;12(2):265-71.

Li L, Wu Z, Wu S, Zhaoc Y, Jia M, Yan Z. HIV-Related Stigma in Health Care Settings: A Survey of Service Providers in China. AIDS Patient Care and STDs. 2007;21(10):753-62.

Vaz FS, Ferreira AMA, Motghare DD, Kulkarni MS. Discriminatory Attitudes of a Rural Community Towards People with HIV/AIDS: Experiences From Goa. Indian J Community Med. 2005;30(2):73.

Taraphdar P, Dasgupta A, Saha B, Disclosure among people living with HIV/AIDS. Indian J Community Med. 2007;30(4):80-2.

Wolitski RJ, Pals SL, Kidder DP, Courtenay-Quirk C, Holtgrave DR. The Effects of HIV Stigma on Health, Disclosure of HIV Status, and Risk Behavior of Homeless and Unstably Housed Persons Living with HIV. AIDS and Behavior. 2009;13(6):1222-32.