Living With HIV in Silence: Stigma, Disclosure and Barriers to Antiretroviral Therapy Among Women in Indonesia
4 affiliations
- 1Universitas Airlangga Surabaya Indonesia unair.ac.id
- 2STIKes Hutama Abdi Husada Tulungagung Tulungagung Indonesia
- 3Universitas Negeri Malang Malang Indonesia um.ac.id
- 4Universitas Jember Jember Indonesia unej.ac.id
Abstract
Background: Although antiretroviral therapy (ART) has improved survival among people living with HIV, stigma and psychosocial barriers continue to hinder treatment adherence, particularly among women in collectivist and gendered sociocultural contexts. Women often experience HIV infection within intimate partnerships and may face compounded stigma that affects disclosure and engagement in care. However, limited qualitative research has explored how relational and family dynamics shape these experiences in Indonesia.
Aim: To explore the lived experiences of women living with HIV in relation to stigma and barriers to ART adherence and to examine how relational and family dynamics influence treatment engagement.
Methods: A qualitative descriptive study was conducted between February and July 2023 in Indonesia. Twenty‐two women living with HIV were recruited using purposive sampling. Data were collected through semistructured, in‐depth interviews and analysed using thematic analysis following Braun and Clarke’s framework. The study adhered to COREQ guidelines.
Results: Five interconnected themes emerged: (1) relational pathways of HIV transmission, (2) internalised and enacted stigma, (3) negotiating disclosure, (4) physical and psychological barriers to ART and (5) family support as a buffering mechanism. HIV infection frequently occurred within intimate partnerships, reflecting relational vulnerability. Stigma influenced emotional well‐being, disclosure decisions and treatment engagement. Medication side effects, treatment fatigue and perceived wellness contributed to adherence challenges. Family support mitigated stigma‐related distress and facilitated sustained ART adherence.
Conclusion: Women’s experiences of HIV are shaped by relational and sociocultural dynamics that influence stigma, disclosure and adherence. Gender‐sensitive, stigma‐informed and family‐inclusive nursing interventions are essential to strengthen long‐term treatment engagement among women living with HIV.
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BibTeX
@article{sukartini2026living,
title = {{Living With HIV in Silence: Stigma, Disclosure and Barriers to Antiretroviral Therapy Among Women in Indonesia}},
author = {Tintin Sukartini and Nursalam and Erna Dwi Wahyuni and Rio Ady Erwansyah and Achmad Masfi and Ronal Surya Aditya},
journal = {AIDS Research and Treatment},
year = {2026},
month = nov,
doi = {10.1155/arat/7327626},
url = {https://doi.org/10.1155/arat/7327626},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Living With HIV in Silence: Stigma, Disclosure and Barriers to Antiretroviral Therapy Among Women in Indonesia
AU - Tintin Sukartini
AU - Nursalam
AU - Erna Dwi Wahyuni
AU - Rio Ady Erwansyah
AU - Achmad Masfi
AU - Ronal Surya Aditya
PY - 2026
DA - 2026/11/04
JO - AIDS Research and Treatment
DO - 10.1155/arat/7327626
UR - https://doi.org/10.1155/arat/7327626
AB - Background: Although antiretroviral therapy (ART) has improved survival among people living with HIV, stigma and psychosocial barriers continue to hinder treatment adherence, particularly among women in collectivist and gendered sociocultural contexts. Women often experience HIV infection within intimate partnerships and may face compounded stigma that affects disclosure and engagement in care. However, limited qualitative research has explored how relational and family dynamics shape these experiences in Indonesia. Aim: To explore the lived experiences of women living with HIV in relation to stigma and barriers to ART adherence and to examine how relational and family dynamics influence treatment engagement. Methods: A qualitative descriptive study was conducted between February and July 2023 in Indonesia. Twenty‐two women living with HIV were recruited using purposive sampling. Data were collected through semistructured, in‐depth interviews and analysed using thematic analysis following Braun and Clarke’s framework. The study adhered to COREQ guidelines. Results: Five interconnected themes emerged: (1) relational pathways of HIV transmission, (2) internalised and enacted stigma, (3) negotiating disclosure, (4) physical and psychological barriers to ART and (5) family support as a buffering mechanism. HIV infection frequently occurred within intimate partnerships, reflecting relational vulnerability. Stigma influenced emotional well‐being, disclosure decisions and treatment engagement. Medication side effects, treatment fatigue and perceived wellness contributed to adherence challenges. Family support mitigated stigma‐related distress and facilitated sustained ART adherence. Conclusion: Women’s experiences of HIV are shaped by relational and sociocultural dynamics that influence stigma, disclosure and adherence. Gender‐sensitive, stigma‐informed and family‐inclusive nursing interventions are essential to strengthen long‐term treatment engagement among women living with HIV.
SN - 2090-1240
SN - 2090-1259
ER -