Unveiling the Hidden Truth: Self-Stigma and HIV Disclosure among Sub-Saharan African Migrant Women in Belgium

Abstract

Antiretroviral treatment has significantly reduced AIDS-related deaths but the increased number of people 
living with HIV/AIDS and experiencing stigma remains a global health challenge. Self-stigma deeply affects 
the lives of people with HIV/AIDS and may thwart prevention efforts. This paper explores the drivers of self
stigma, experiences and the coping strategies common to HIV-positive sub-Saharan African (SSA) migrant 
women in Belgium. Qualitative study of 40 SSA migrant women was conducted between April 2013 and 
December 2014. Participants were recruited through purposive sampling and snowball techniques from AIDS 
Reference Centers and AIDS workshops in Belgium; if 18 years and older, French or English speaking, and 
diagnosed HIV-positive more than 3 months. We conducted semi-structured interviews with patients and did 
observations during consultations and support groups attendances. Follow-up interviews were conducted 
four to eight months later. Thematic analysis was used to identify themes, aided by NVivo 8 as they emerged 
from data. Self-stigma was ubiquitous in the lives of almost all participants, driven by: public endorsed 
negative feelings, chronic/incurable nature of disease, HIV transmission misconceptions. The most striking 
implications of HIV self-stigma include: reluctance to seek treatment/care, unwillingness to disclose HIV+ 
status. Participants reported that disclosure/non-disclosure, treatment adherence, faith in God, empathy and 
support help them cope HIV/AIDS self-stigma. Our findings highlight the complex and shifting nature of self
stigma experienced by SSA migrant women living with HIV/AIDS in Belgium. There is urgent need for 
innovative culturally-adapted self-stigma reduction programs that will improve personalized support services 
and optimize HIV prevention and treatment.