\u201cIt is not an acceptable disease\u201d: A qualitative study of HIV-related stigma and discrimination and impacts on health\xa0and wellbeing for people from ethnically diverse backgrounds in Australia

Anna Ziersch,Georgia Rowley,Enaam Oudih,Moira Walsh,Melanie Baak,Lillian Mwanri

doi:10.1186/s12889-021-10679-y

Abstract

BackgroundPeople from ethnically diverse backgrounds living with HIV are susceptible to adverse health and wellbeing outcomes, particularly as a consequence of HIV-related stigma and discrimination (HSD), though relatively little is known about experiences in Australia.MethodsThis paper reports on HSD in ethnically diverse communities in South Australia and impacts on health and wellbeing. Interviews and focus groups were conducted with 10 individuals living with HIV from ethnically diverse backgrounds, 14 ethnically diverse community leaders, and 50 service providers. Data were analysed thematically.ResultsFindings indicated that HIV is a highly stigmatised condition in ethnically diverse communities due to fear of moral judgment and social isolation, and was experienced at the intersections of gender, sexual orientation, religion, culture, and immigration status. Experiences of HSD were damaging to health and wellbeing through non-disclosure, reduced social support, delayed testing, service access barriers, impacts on treatment adherence, and directly to mental health.ConclusionsActions addressing the impacts of HSD on people from ethnically diverse backgrounds are crucial.

Highlights

People from ethnically diverse backgrounds living with HIV are susceptible to adverse health and wellbeing outcomes, as a consequence of HIV-related stigma and discrimination (HSD), though relatively little is known about experiences in Australia
The Australian Bureau of Statistics (ABS) defines the Culturally and Linguistically Diverse’ (CALD) population as people from a range of different countries or ethnic and cultural groups according to country of birth and year of arrival in Australia, parents’ country of birth, language spoken at home, English proficiency, and religious affiliation [4]
The project was conducted in partnership with a not-for-profit organisation with a program working with people living with HIV (PLHIV) from CALD backgrounds, and ethics approval was obtained from that organisation

Summary

Introduction

People from ethnically diverse backgrounds living with HIV are susceptible to adverse health and wellbeing outcomes, as a consequence of HIV-related stigma and discrimination (HSD), though relatively little is known about experiences in Australia. PLHIV from ethnically diverse communities and impacts of this on health and wellbeing (hereafter 'health'). We recognise the use of terminology to describe groups of people based on ethnic and migrant background is a cause of debate. In Australia, the generally accepted phrasing is ‘Culturally and Linguistically Diverse’ (CALD) communities or background. The Australian Bureau of Statistics (ABS) defines the CALD population as people from a range of different countries or ethnic and cultural groups according to country of birth and year of arrival in Australia, parents’ country of birth, language spoken at home, English proficiency, and religious affiliation [4]. Given the Australian focus of this empirical study and the Australian organisations we worked with, we use the term ‘CALD’ throughout the rest of the paper

Methods

Results

Conclusion