Intersectional Stigma Among People Transitioning From Incarceration to Community-Based HIV Care in Gauteng Province, South Africa

AIDS Educ Prev. 2021 Jun;33(3):202-215. doi: 10.1521/aeap.2021.33.3.202.

Abstract

People transitioning from incarceration to community-based HIV care experience HIV stigma, incarceration stigma, and the convergence of these stigmas with social inequities. The objective of this study is to understand intersectional stigma among people returning from incarceration with HIV in Gauteng Province, South Africa. Qualitative interviews were conducted with 42 study participants. We analyzed transcript segments and memos from these interviews. Our results showed that anticipated HIV stigma increased participants' difficulty with disclosure and treatment collection. Incarceration stigma, particularly the mark of a criminal record, decreased socioeconomic stability in ways that negatively affected medication adherence. These stigmas converged with stereotypes that individuals were inherently criminal "bandits." Male participants expressed concerns that disclosing their HIV status would lead others to assume they had engaged in sexual activity with men while incarcerated. AIDS education and prevention efforts will require multilevel stigma interventions to improve HIV care outcomes.

Keywords: HIV; South Africa; incarceration; intersectionality; stigma.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Community Health Services / organization & administration*
  • Continuity of Patient Care*
  • Disclosure
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • HIV Infections / psychology*
  • Humans
  • Interviews as Topic
  • Male
  • Medication Adherence / psychology*
  • Middle Aged
  • Prisoners*
  • Qualitative Research
  • Sexual Behavior
  • Social Stigma*
  • South Africa / epidemiology