Community and healthcare provider perspectives on HIV- and COVID-19–related stigma, fear and health-seeking barriers among pregnant and breastfeeding women in Uganda
Abstract
Background: Stigma and fear associated with HIV/AIDS and COVID-19 remain major barriers to healthcare access, particularly for pregnant and breastfeeding women. These intersecting social processes may undermine health-seeking behaviour, treatment adherence, and maternal health outcomes. The study explored experiences of HIV stigma, COVID-19–related fear, and health-seeking barriers among pregnant and breastfeeding women, healthcare workers, and community stakeholders in Uganda.
Methods: A qualitative study was conducted in selected districts in Uganda in March-July 2025. Data were collected using 12 focus group discussions (FGDs), 24 in-depth interviews (IDIs), and 21 key informant interviews (KIIs). Participants included pregnant and breastfeeding women, healthcare workers, and community stakeholders, selected purposively. Interviews were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis using Nvivo version 12 software guided by the Social Ecological Model.
Results: HIV stigma was pervasive, expressed through gossip, discrimination, secrecy, and moral judgment, shaping disclosure and access to care. COVID-19–related fear intensified social isolation, movement restrictions, and unintended disclosure of HIV status. The coexistence of both conditions created layered stigma that disrupted antenatal attendance, ART adherence, and household relationships. Despite these barriers, participants demonstrated resilience driven by child protection and survival. Coping strategies included discreet ART delivery, peer support, telehealth communication, and community sensitization. Trust in healthcare workers and confidentiality were central to service utilization.
Conclusions: Intersecting HIV and COVID-19 stigma and fear appeared to contribute to barriers in maternal health-seeking among women in Uganda. These influences may be reduced through targeted approaches such as confidential service delivery, peer-led support, and community education. Integrating stigma-sensitive practices into maternal and HIV care services could help strengthen trust, support service use, and improve maternal health outcomes during concurrent public health challenges.
Related
- Healthcare provider and patient perspectives on barriers and facilitators to accessing maxillofacial injury care in Lesotho: a qualitative study
- Accessibility of essential medicines and vaccines among fisherfolk, artisanal miners and pastoralists in Mainland Tanzania: a qualitative study of barriers and strategies from the perspectives of healthcare professionals and community leaders.
- Barriers to Effective Type 2 Diabetes Care in a Conflict-Affected Region of Syria: A Qualitative Study of Health Care Provider Perspectives
- A decade of implementing comprehensive child development services in Northwest Iran: a qualitative study of provider perspectives on barriers and facilitators
- Community-Delivered Antenatal Care to Address Access Barriers: Perspectives of Women and Healthcare Workers
BibTeX
@article{twimukye2026community,
title = {{Community and healthcare provider perspectives on HIV- and COVID-19–related stigma, fear and health-seeking barriers among pregnant and breastfeeding women in Uganda}},
author = {Adelline Twimukye and Catriona Waitt and Paul Gonza and Charles Owuor Olungah},
journal = {BMC Public Health},
year = {2026},
month = oct,
doi = {10.1186/s12889-026-29779-8},
url = {https://link.springer.com/10.1186/s12889-026-29779-8},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Community and healthcare provider perspectives on HIV- and COVID-19–related stigma, fear and health-seeking barriers among pregnant and breastfeeding women in Uganda
AU - Adelline Twimukye
AU - Catriona Waitt
AU - Paul Gonza
AU - Charles Owuor Olungah
PY - 2026
DA - 2026/10/10
JO - BMC Public Health
DO - 10.1186/s12889-026-29779-8
UR - https://link.springer.com/10.1186/s12889-026-29779-8
AB - Background: Stigma and fear associated with HIV/AIDS and COVID-19 remain major barriers to healthcare access, particularly for pregnant and breastfeeding women. These intersecting social processes may undermine health-seeking behaviour, treatment adherence, and maternal health outcomes. The study explored experiences of HIV stigma, COVID-19–related fear, and health-seeking barriers among pregnant and breastfeeding women, healthcare workers, and community stakeholders in Uganda. Methods: A qualitative study was conducted in selected districts in Uganda in March-July 2025. Data were collected using 12 focus group discussions (FGDs), 24 in-depth interviews (IDIs), and 21 key informant interviews (KIIs). Participants included pregnant and breastfeeding women, healthcare workers, and community stakeholders, selected purposively. Interviews were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis using Nvivo version 12 software guided by the Social Ecological Model. Results: HIV stigma was pervasive, expressed through gossip, discrimination, secrecy, and moral judgment, shaping disclosure and access to care. COVID-19–related fear intensified social isolation, movement restrictions, and unintended disclosure of HIV status. The coexistence of both conditions created layered stigma that disrupted antenatal attendance, ART adherence, and household relationships. Despite these barriers, participants demonstrated resilience driven by child protection and survival. Coping strategies included discreet ART delivery, peer support, telehealth communication, and community sensitization. Trust in healthcare workers and confidentiality were central to service utilization. Conclusions: Intersecting HIV and COVID-19 stigma and fear appeared to contribute to barriers in maternal health-seeking among women in Uganda. These influences may be reduced through targeted approaches such as confidential service delivery, peer-led support, and community education. Integrating stigma-sensitive practices into maternal and HIV care services could help strengthen trust, support service use, and improve maternal health outcomes during concurrent public health challenges.
SN - 1471-2458
ER -