Narratives of Women Living with HIV: Coping with Shame, Guilt, and Stigma

Background and Purpose:
Although women constitute nearly half of the global population living with HIV, their lived experiences remain critically underrepresented in both academic research and public discourse. The dominant framing of HIV as primarily affecting men who have sex with men, combined with the stigmatization of women associated with marginalized groups (e.g., sex workers, women who inject drugs), contributes to narratives that obscure the psychosocial realities of women living with HIV. This study seeks to explore how women navigate the intersecting challenges of shame, guilt, and stigma following an HIV diagnosis. The central research question asks: How do women living with HIV experience and cope with stigma, and how does it shape their emotional well-being, relationships, and interactions with healthcare systems?

Methods:
This qualitative study employed a narrative research design to capture the complex, subjective experiences of ten HIV-positive women. Participants were recruited using purposive sampling from community health organizations and support networks. Data collection involved semi-structured, in-depth interviews conducted in a confidential setting. The interviews were transcribed and analyzed using thematic narrative analysis, allowing for the identification of recurring motifs, coping strategies, and meaning-making processes embedded in personal stories.

Results:
Findings reveal pervasive internalized stigma, manifesting as shame, guilt, and fear of social rejection. Participants described struggles with disclosure, concern over familial judgment, and diminished self-worth. Despite these challenges, narratives also highlighted resilience and adaptive coping mechanisms, such as selective disclosure, activism, peer support, and redefined self-identity. Many women reported negative encounters with healthcare providers, often stemming from gendered assumptions and moralizing attitudes, underscoring the need for more empathetic, informed care.

Conclusions and Implications:
The study underscores the urgent need for trauma-informed, gender-sensitive interventions that address both the emotional and structural dimensions of stigma. Implications for social work practice include developing culturally competent support systems, training healthcare providers in nonjudgmental communication, and integrating women’s voices into policy design. By foregrounding the lived realities of women living with HIV, this research contributes to efforts aimed at reducing stigma, promoting mental health, and advancing social justice in healthcare contexts.