Social stigma, discrimination, and their determinants among people living with HIV and AIDS in Sudurpashchim Province, Nepal

Introduction: Human immunodeficiency virus (HIV)-related stigma and discrimination adversely affect health, quality of life, social support, and well-being of people living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHA).This study assessed the perceived stigma and discrimination, and their determinants among PLWHA living in Sudurpashchim Province of Nepal.Material and methods: This study adapted cross-sectional survey in 2020 to sample 167 PLWHA using semi-structure questionnaire.Information about socio-demographic characteristics, stigma domain, and discrimination domain were obtained through face-to-face interviews.Bivariate and multivariate logistic regression models were applied to identify factors associated with perceived stigma and discrimination among PLWHA.Results: The overall stigma was 70%, and discrimination was 34%.In the multivariate logistic regression, male gender (AOR = 2.4; 95% CI: 1.04-6.62%;p-value = 0.009), age (AOR = 1.09; 95% CI: 1.03-1.15%;p-value < 0.001), high level of public health concerns (AOR = 12.9; 95% CI: 8.9-37.5%;p < 0.001), and high level of negative self-image (AOR = 10.3;95% CI: 8.8-39.6%;p < 0.001) were factors significantly associated with higher perceived stigma.Similarly, female gender (AOR = 15.4;95% CI: 8.2-35.3%;p < 0.001) and high level of perceived community support (AOR = 8.86; 95% CI: 3.86-32.1%;p < 0.001) were factors significantly associated with higher perceived discrimination.Conclusions: Stigma and discrimination remain pervasive among PLWHA in Sudurpashchim Province and most originate from communities, presenting negative impacts on PLWHA.Unprecedented measures to enhance the awareness of PLHIV, their families, and community about perceived stigma and associated factors are needed to reduce stigma, and to achieve the commitments of fast-tracking towards ending the AIDS epidemic.