HIV Stigma, HIV status disclosure, and ART adherence in the context of an integrated opioid use disorder and HIV treatment setting in Dar es Salaam, Tanzania

ABSTRACT

Little is known about social factors, including stigma, that affect antiretroviral therapy (ART) adherence among people enrolled in opioid use disorder treatment (OUDT) in the context of integrated OUDT and HIV treatment models. We qualitatively examined the relationship between HIV stigma, HIV status disclosure, and ART adherence among clients living with HIV at an OUDT clinic with integrated HIV services in Tanzania. We conducted in-depth interviews with 25 clients receiving HIV care at an OUDT clinic in Dar es Salaam, Tanzania between January and April 2020. HIV stigma, particularly anticipated stigma, and HIV status disclosure were key factors that affected ART adherence. Participants feared non-voluntary HIV status disclosure to and HIV stigma from their peers enrolled in OUDT. Most participants reported concealing their HIV status from peers at the OUDT clinic and not associating with other clients living with HIV at the clinic. Reducing HIV stigma and enhancing clinic structures and procedures to maintain privacy and confidentiality are essential to mitigating the effects of stigma on ART adherence.

KEYWORDS:

• ART adherence
• social networks
• HIV status disclosure
• HIV stigma
• opioid use disorder treatment

Acknowledgements

We would like to acknowledge the research participants who offered us their time for the study. We would also like to thank our field data collectors who conducted the interviews. This research was supported by the U.S. National Institute on Drug Abuse (K01DA047142).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by U.S. National Institute on Drug Abuse [Grant number K01DA047142].