Exploring HIV-related stigma and its impact on ethnic Mizo people living with HIV in Mizoram, Northeast India: a prospective observational study

Background: In India, despite significant advancements in Antiretroviral Therapy (ART), stigma and discrimination remain major barriers for people living with HIV (PLHIV), often hindering ART adherence and compromising treatment outcomes. This study aimed to assess the determinants and contributing factors of HIV-related stigma among PLHIV in Mizoram, a northeastern state with one of the highest HIV prevalence rates in the country. Methods: A cross-sectional study was conducted among 300 PLHIV attending the ART Center, in Aizawl, Mizoram. Descriptive statistics, Chi-square tests, and binary logistic regression were used to assess factors associated with stigma and treatment adherence. Results: A total of 300 PLHIV were enrolled in the study, comprising 176 (58.7%) males and 124 (41.3%) females. In the internalized stigma domain, males experienced significantly higher stigma compared to females (aOR = 2.394, CI = 1.294–4.426, p = 0.005). In the felt-normative stigma domain, participants aged 41–50 years reported higher stigma levels compared to aged 51 years and above (aOR = 0.329, CI = 0.110–0.985, p = 0.047). Regarding medication adherence, 208 (69.3%) participants demonstrated optimal adherence to ART, while 92 (30.7%) had sub-optimal adherence. Conclusion: Most PLHIV in our study reported low to moderate stigma across domains. To reduce HIV related stigma among PLHIV, one should prioritize patient centric counselling, educational interventions in the form of mass communication, printed media etc., to ensure their psychological well-being and to create educational awareness involving the community and healthcare professionals to promote more positive thoughts on HIV which will reduce HIV related stigma in the society.