Stigma as a barrier to HIV care: a single center study in Egypt

Stigma entails labeling individuals and associating them with negative stereotypes, often resulting in social isolation, discrimination, and loss of social status. In the context of HIV/AIDS, stigma remains a significant barrier to effective prevention, treatment, and care. This study aimed to assess the level of HIV-related stigma among people living with HIV (PLWH) in an HIV cure center at Alexandria Fever Hospital, serving cities in northern Egypt. A cross-sectional study was conducted among 785 PLWH attending the HIV unit at Alexandria Fever Hospital. Data was collected through structured interviews using a sociodemographic questionnaire and the Arabic-translated, 12-item short version of the HIV Stigma Scale, which demonstrated good reliability (Cronbach's alpha = 0.743). Results revealed that 72.4% of participants experienced high levels of stigma, indicated by a total stigma score greater than 30. Male participants reported significantly higher stigma scores than females (60.8% vs. 23.0%, respectively, with a median score of 33 or higher). Stigma scores were also associated with residence within Alexandria city (p < 0.05) but showed no association with educational level. In conclusion, PLWH in Alexandria face a high burden of stigma, particularly among men. These findings underscore the need for targeted psychosocial and community-based interventions to reduce stigma and support affected individuals.