An exploration into perceived stigma, discrimination, and psychological wellbeing among people living with HIV in Bhutan

Abstract

Introduction: HIV-related stigma and discrimination affect health and wellbeing and pose greater challenges to PLHIV. Stigma and discrimination remain as a major obstacle in curbing HIV epidemic, undermining HIV prevention efforts including uptake of voluntary testing, counseling, access to HIV treatment services and care. This study explored the experience of stigma and discrimination and its perceived influence on the psychological well-being of PLHIV in Bhutan. Methods: Explorative qualitative in-depth interviews were completed with 28 PLHIV in four geographical locations Thimphu, Phuntsholing, Gelephu, and Samdrupjongkhar, Bhutan. Participants were interviewed on the experience of stigma and discrimination and the perceived influence on their psychological wellbeing. Results: About 43% participants, slightly more among females, mentioned having experienced stigma and faced discrimination. Content analysis revealed individuals in the community, family members and relatives, workstations and healthcare providers as the potential sources of stigma and discrimination. Two-third of the participants appeared to have better psychological wellbeing. Nevertheless, about 36% admitted either feeling sad, worried, or lonely due to their HIV status. Introspection, support from family, relatives and friends, and meditation were perceived to help alleviate negative thoughts about HIV status and its influence. Conclusions: Despite vigorous advocacy and awareness campaign, HIV related stigma and discrimination is still prevalent in the Bhutanese society influencing psychological wellbeing among PLHIV. Findings provided important insights meriting the designing of effective interventions including the involvement of certified counselors to counter stigma and discrimination, promote wellbeing and positive living among PLHIV in Bhutan