We Keep her Status to ourselves': Experiences of Stigma and Discrimination among HIV-Discordant Couples in South Africa; Tanzania and Ukraine

ABSTRACT

In HIV-discordant relationships; the HIV-negative partner also carries the burden of a stigmatised disease. For this reason; couples often hide their HIV-discordant status from family; friends and community members. This perpetuates the silence around HIV-discordant relationships and impacts on targeted HIV prevention; treatment and counselling efforts. This article reports on experiences of stigma and discrimination among HIV-discordant couples in South Africa; Tanzania and Ukraine. During 2008; HIV-discordant couples who had been in a relationship for at least one year were recruited purposively through health-care providers and civil society organisations in the three countries. Participants completed a brief self-administered questionnaire; while semi-structured interviews were conducted with each partner separately and with both partners together. Interviews were analysed using thematic content analysis. Fifty-one couples were recruited 26 from South Africa; 10 from Tanzania; and 15 from Ukraine. Although most participants had disclosed their HIV status to someone other than their partner; few were living openly with HIV discordance. Experiences of stigma were common and included being subjected to gossip; rumours and name-calling; and HIV-negative partners being labelled as HIV-positive. Perpetrators of discrimination included family members and health workers. Stigma and discrimination present unique and complex challenges to couples in HIV sero-discordant relationships in these three diverse countries. Addressing stigmatisation of HIV-discordant couples requires a holistic human rights approach and specific programme efforts to address discrimination in the health system