Leaving no one behind? Addressing inequitable HIV outcomes by attending to diversity

A qualitative study exploring the needs of LGBTQI+ young people living with HIV in Zimbabwe

Bibliographic Data

ID19594360
AuthorsJoni Lariat (0000-0003-1240-6916, The University of Sydney, corresponding author), Webster Mavhu (0000-0003-1881-4398, Liverpool School of Tropical Medicine, corresponding author), Thandiwe Mudhumo (0009-0006-7955-252X, corresponding author), Pueshpa Shaba (Centre for Sexual Health and HIV AIDS Research, corresponding author), Sharon Sibanda (0000-0002-6595-4097, Centre for Sexual Health and HIV AIDS Research, corresponding author), Rufaro Mbundure (Centre for Sexual Health and HIV AIDS Research, corresponding author), Carol Wogrin (0000-0001-9066-8845, corresponding author), Abigail Mutsinze (0000-0003-0668-3343, corresponding author), Nicola Willis (0000-0003-0452-0196, corresponding author), Bernay (0000-0001-7628-8408, The University of Sydney, corresponding author), Sarah Bernays
EditorsHannah Hogan Leslie
Year2024
Volume4
Issue1
Pagese0002442
Publication date2024-01-25
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0002442
PMID38271434
OpenAlexW4391216326
LanguageEN
Citations received5
References cited42

Leaving nobody behind in the fight to end the HIV epidemic as a public health threat depends on addressing inequities in optimal HIV outcomes. Consistently overlooked in research, policy and programming are young lesbian, gay, bisexual, transgender, queer/questioning and intersex (LGBTQI+) people who are living with HIV. This study engaged young LGBTQI+ people in Zimbabwe to better understand their experiences of living with HIV and the support they need. Between September 2022 and February 2023, we conducted qualitative research with 14 LGBTQI+ young people (18–24 years), (two focus group discussions and in-depth interviews with 5/14). All 14 participants were accessing a LGBTQI+ HIV support group at Zvandiri (‘As I Am’), a well-established community-based HIV program. We conducted thematic analysis and key findings informed the collaborative development of internal activities to further enhance inclusivity of LGBTQI+ young people within Zvandiri’s programs. There was consensus among participants that being LGBTQI+ and living with HIV leads to “double stigma and double trouble” , involving physical and verbal harassment, social exclusion and family rejection. Participants concealed their LGBTQI+ identity and HIV status in most situations, and many withheld their HIV status in LGBTQI+ social spaces, including community-led LGBTQI+ services. This negatively impacted their psychosocial well-being and social connectedness. Participants described positive experiences of Zvandiri. Interacting with others living with HIV in a destigmatising environment promoted self-acceptance. However, reflecting their prevailing experiences, participants were cautious about revealing their sexuality and/or gender identity at Zvandiri outside of their support group. Ensuring equitable access to HIV care, including mental health support, relies on understanding the challenges experienced by those most marginalised. Critically important is understanding the impact of intersectional stigma on LGBTQI+ young peoples’ social lives, and their access to services. Community-based HIV support programs are well-positioned to support and advance this group’s health rights

Focus group · Human sexuality · Lesbian · Psychosocial · Psychotherapist · Qualitative research · Social support · Sociology · Thematic analysis · Transgender · Adolescent Sexual and Reproductive Health · Gender Studies · HIV/AIDS Research and Interventions · LGBTQ Health, Identity, and Policy · Medicine · Psychology · Social Psychology