HIV-related stigma experiences: Understanding gender disparities in Thailand

This paper assesses the relationship between gender and HIV-related stigma experiences among people living with HIV (PLHIV) - enacted and anticipated stigma - and PLHIV caregivers - courtesy stigma - in Northern Thailand, along with the underlying reasons for stigmatising attitudes towards PLHIV - instrumental and symbolic stigma - expressed in the general population. We used data from the Living With Antiretrovirals (LIWA) study conducted on all PLHIV receiving antiretroviral treatment in four district hospitals in Northern Thailand (n = 513) and on a community sample of adults from the general population (n = 500). Women living with HIV and female caregivers of PLHIV reported higher rates of HIV-related stigma experiences than men. Gender interacted with other predictors - the period of HIV diagnosis and age - to increase the level of stigma experienced. Among the general population, attitudes of contact avoidance were infrequent. However, stereotypes depicting PLHIV as blameworthy were highly pervasive, with women perceived as the "victims" of their spouse's irresponsible sexual behaviours. In this context, women were yet more often subjected to HIV-related stigma than men, in particular women diagnosed in the pre-antiretroviral therapy era and younger female caregivers. The role of gender in shaping disparities in HIV-related stigma experiences is discussed.