Perspectives of the influence of stigma on care-seeking behavior among ethnic Russians living with HIV/AIDS in Ida-Virumaa, Estonia

Abstract

Since 2001, Estonia has been struggling to contain its explosive HIV epidemic, yet despite years of interventions, adherence to antiretroviral therapy remains between 20% and 40%. The purpose of this research was to examine how HIV stigma is influencing care-seeking behaviour of people living with HIV (PLWHIV) in Ida-Virumaa County, Estonia. This study identified that HIV stigma presents a serious challenge for PLWHIV. The findings not only identified clear cultural metaphors and stigma of HIV and PLWHIV, but also identified that fear of disclosure of status and discrimination from healthcare providers represent significant barriers to care for PLWHIV. The findings also identified that the combination of HIV stigma, fear of disclosure, discrimination from healthcare providers and certain state policies have fostered an environment of structural discrimination that not only limits PLWHIV in Ida-Virumaa ability to access care, but also pushes them away from the healthcare system.