A focus group qualitative study of HIV stigma in the Canadian healthcare system

Stigma related to HIV in the healthcare system has a pervasive, negative impact on the mental, physical and sexual health of people living with HIV. While well-documented before the advent of antiretroviral treatment, this stigma in Canada has not been as thoroughly examined from a critical perspective since HIV's evolution from an acute to a chronic illness. The current study examines attitudes and beliefs of healthcare providers toward people living with HIV through the use of focus groups. Focus group participants were women living with HIV, men living with HIV, medical and nursing students, and health care providers working with people living with HIV. Data analysis was conducted with a critical lens using an immersion/crystallization approach. Two broad themes emerged from the data: HIV-specific experiences, and components of stigma. Both negative and positive experiences were described. Discrimination, as a behavioural act, was deemed to be the less prevalent and often more covert expression of stigmatization. Stereotyping, including with regard to perceived sexuality, and prejudice were seen as more insidious and perpetuated by both the medical and educational establishments. These findings clearly demonstrate the need for change in terms of reducing the amount of stigma present in these complex, nuanced, and enduring relationships between people living with HIV and the health care system.