Applying the Social Ecological Model to Explore HIV-Related Stigma in Florida: A Qualitative Study

The purpose of this study is to describe human immunodeficiency virus (HIV)-related stigma and strategies to reduce it in Florida within the context of the social ecological model (SEM). Qualitative surveys were distributed at community events, advisory meetings, and conferences via electronic and paper-based methods to persons living with and without HIV over an 8-month period in 2018. A directed content analysis was used to code the responses of 76 participants (33 persons living with HIV, 43 without HIV) into five levels of the SEM (individual, interpersonal, community, institutional, and structural). Within each level, multiple themes and subthemes emerged: individual-knowledge, fear, internalization; interpersonal-social network; community-judgments, discrimination, community organizations, norms; institutional-competent providers, health care services; and structural-systemic barriers, language, and education. The findings exemplify the need for a multilevel approach that incorporates the perspectives of people with and without HIV to reduce HIV-related stigma in Florida.