{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T11:34:19Z","timestamp":1774524859203,"version":"3.50.1"},"reference-count":45,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T00:00:00Z","timestamp":1630627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>HIV\/AIDS stigma is a global issue and a serious problem in African countries. Although prevalence remains high in this region, no detailed study has yet been carried out to determine and characterize this problem in Burundi. Using a qualitative analysis based on an extensive series of 114 interviews, we describe the main characteristics of HIV stigma in the country. The results of our study indicate that the problem of HIV\/AIDS stigma is widespread in Burundian society, as all participants in the research reported having experienced some kind of HIV stigma. The seven dimensions of stigma identified in people living with HIV\/AIDS (PLWHA) in Burundi are physical violence, verbal violence, marginalization, discrimination, self-stigma, fear and insecurity, and healthcare provider stigma. These dimensions of stigma can be experienced through different manifestations, which have been characterized in this study, revealing that the problem of stigma in PLWHA is still an important issue in Burundi.<\/jats:p>","DOI":"10.3390\/ijerph18179300","type":"journal-article","created":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T13:15:56Z","timestamp":1630934156000},"page":"9300","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["HIV\u2013AIDS Stigma in Burundi: A Qualitative Descriptive Study"],"prefix":"10.3390","volume":"18","author":[{"given":"N\u00e9stor","family":"Njejimana","sequence":"first","affiliation":[{"name":"Escuela de Doctorado, Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir, 46001 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc\u00eda","family":"G\u00f3mez-Tatay","sequence":"additional","affiliation":[{"name":"Institute of Life Sciences, Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir, 46001 Valencia, Spain"},{"name":"Grupo de Medicina Molecular y Mitocondrial, Facultad de Ciencias de la Salud, Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir, 46001 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Miguel","family":"Hern\u00e1ndez-Andreu","sequence":"additional","affiliation":[{"name":"Institute of Life Sciences, Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir, 46001 Valencia, Spain"},{"name":"Grupo de Medicina Molecular y Mitocondrial, Facultad de Ciencias de la Salud, Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir, 46001 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,3]]},"reference":[{"key":"ref_1","unstructured":"Ministere de la sant\u00e9 Publique et de la lutte Contre le SIDA [Burundi] (MSPLS), and Conseil National de Lutte Contre le SIDA [Burundi] (CNLS) (2021, September 02). Plan Estrat\u00e9gique National de Lutte Contre le SIDA 2012\u20132016, Available online: https:\/\/www.ilo.org\/wcmsp5\/groups\/public\/---ed_protect\/---protrav\/---ilo_aids\/documents\/legaldocument\/wcms_202048.pdf."},{"key":"ref_2","unstructured":"Minist\u00e8re \u00e0 la pr\u00e9sidence Charg\u00e9 de la Bonne Gouvernance et du Plan [Burundi] (MPBGP), Minist\u00e8re de la sant\u00e9 Publique et de la lutte Contre le SIDA [Burundi] (MSPLS), Institut de Statistiques et d\u2019\u00e9tudes \u00e9conomiques du Burundi (ISTEEBU), and et ICF (2018). Enqu\u00eate D\u00e9mographique et de Sant\u00e9 au Burundi 2016\u20132017: Rapport de Synth\u00e8se, ICF. Available online: https:\/\/dhsprogram.com\/pubs\/pdf\/SR247\/SR247.pdf."},{"key":"ref_3","unstructured":"Programme Commun des Nations Unies sur le VIH\/sida (ONUSIDA), and Conseil National de Lutte Contre le SIDA [Burundi] (CNLS) (2015). Rapport d\u2019activit\u00e9s sur la lutte Contre le SIDA et le Rapport sur les Progres Enrogistr\u00e9s vers l\u2019acc\u00e8s Universal (Burundi), CNLS. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/country\/documents\/BDI_narrative_report_2015.pdf."},{"key":"ref_4","unstructured":"World Health Organization (WHO) (2016). Global Health Sector Strategy on HIV 2016\u20132021. Towards Ending AIDS, WHO. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/246178."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"145891","DOI":"10.1155\/2009\/145891","article-title":"Stigma of People with HIV\/AIDS in Sub-Saharan Africa: A Literature Review","volume":"2009","author":"Mbonu","year":"2009","journal-title":"J. Trop. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1007\/s10461-013-0437-9","article-title":"HIV stigma mechanisms and well-being among PLWH: A test of the HIV stigma framework","volume":"17","author":"Earnshaw","year":"2013","journal-title":"AIDS Behav."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.socscimed.2007.03.015","article-title":"Meta-analysis of stigma and mental health","volume":"65","author":"Mak","year":"2007","journal-title":"Soc. Sci. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/S0006-3223(03)00323-8","article-title":"HIV disease progression: Depression, stress, and possible mechanisms","volume":"54","author":"Leserman","year":"2003","journal-title":"Biol. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1097\/PSY.0b013e3181777a5f","article-title":"Role of depression, stress, and trauma in HIV disease progression","volume":"70","author":"Leserman","year":"2008","journal-title":"Psychosomaic Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1089\/apc.2011.0429","article-title":"Suicidality and anxiety sensitivity in adults with HIV","volume":"26","author":"Capron","year":"2012","journal-title":"AIDS Patient Care STDs"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1176\/appi.ajp.2009.09111565","article-title":"Elevated suicide rate among HIV-positive persons despite benefits of antiretroviral therapy: Implications for a stress and coping model of suicide","volume":"167","author":"Carrico","year":"2010","journal-title":"Am. J. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.2105\/AJPH.2005.082511","article-title":"Factors related to HIV disclosure in 2 South African communities","volume":"97","author":"Norman","year":"2007","journal-title":"Am. J. Public Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/s12160-013-9514-6","article-title":"Internalized stigma, social distance, and disclosure of HIV seropositivity in rural Uganda","volume":"46","author":"Tsai","year":"2013","journal-title":"Ann. Behav. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1089\/apc.2006.20.350","article-title":"A comparison of HIV stigma and disclosure patterns between older and younger adults living with HIV\/AIDS","volume":"20","author":"Emlet","year":"2006","journal-title":"AIDS Patient Care STDs"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1007\/s11606-009-1068-8","article-title":"The association of stigma with self-reported access to medical care and antiretroviral therapy adherence in persons living with HIV\/AIDS","volume":"24","author":"Sayles","year":"2009","journal-title":"J. Gen. Intern. Med."},{"key":"ref_16","unstructured":"World Health Organization (WHO) (2009). HIV Testing, Treatment and Prevention. Generic Tools for Operational Research, WHO. Available online: https:\/\/www.who.int\/hiv\/pub\/operational\/or_generic_tools.pdf?ua=1."},{"key":"ref_17","unstructured":"(2021, September 02). Reduction of HIV-Related Stigma and Discrimination. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/2014unaidsguidancenote_stigma_en.pdf."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Rao, D., Elshafei, A., Nguyen, M., Hatzenbuehler, M.L., Frey, S., and Go, V.F. (2019). A systematic review of multi-level stigma interventions: State of the science and future directions. BMC Med., 17.","DOI":"10.1186\/s12916-018-1244-y"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Van Brakel, W.H., Cataldo, J., Grover, S., Kohrt, B.A., Nyblade, L., Stockton, M., Wouters, E., and Yang, L.H. (2019). Out of the silos: Identifying cross-cutting features of health-related stigma to advance measurement and intervention. BMC Med., 17.","DOI":"10.1186\/s12916-018-1245-x"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1080\/13548500600595327","article-title":"The fight against stigma: An overview of stigma-reduction strategies and interventions","volume":"11","author":"Heijnders","year":"2006","journal-title":"Psychol. Health Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e129","DOI":"10.1016\/S2352-3018(19)30343-1","article-title":"Stigma reduction interventions in people living with HIV to improve health-related quality of life","volume":"7","author":"Andersson","year":"2020","journal-title":"Lancet HIV"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"112749","DOI":"10.1016\/j.socscimed.2019.112749","article-title":"Stigma reduction interventions for children and adolescents in low- and middle-income countries: Systematic review of intervention strategies","volume":"246","author":"Hartog","year":"2020","journal-title":"Soc. Sci. Med."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Ferris France, N., Macdonald, S.H., Conroy, R.R., Chiroro, P., Ni Cheallaigh, D., Nyamucheta, M., Mapanda, B., Shumba, G., Mudede, D., and Byrne, E. (2019). \u2018We are the change\u2019-An innovative community-based response to address self-stigma: A pilot study focusing on people living with HIV in Zimbabwe. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0210152"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1089\/apc.2013.0331","article-title":"Stigma reduction in adolescents and young adults newly diagnosed with HIV: Findings from the Project ACCEPT intervention","volume":"28","author":"Harper","year":"2014","journal-title":"AIDS Patient Care STDs"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3395","DOI":"10.1007\/s10461-018-2174-6","article-title":"Addressing Stigma Through a Virtual Community for People Living with HIV: A Mixed Methods Study of the PositiveLinks Mobile Health Intervention","volume":"22","author":"Flickinger","year":"2018","journal-title":"AIDS Behav."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1007\/s10461-018-2304-1","article-title":"Self-Stigma Reduction Interventions for People Living with HIV\/AIDS and Their Families: A Systematic Review","volume":"23","author":"Ma","year":"2019","journal-title":"AIDS Behav."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e25553","DOI":"10.1002\/jia2.25553","article-title":"Combating HIV stigma in low- and middle-income healthcare settings: A scoping review","volume":"23","author":"Smith","year":"2020","journal-title":"J. Int. AIDS Soc."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Feyissa, G.T., Lockwood, C., Woldie, M., and Munn, Z. (2019). Reducing HIV-related stigma and discrimination in healthcare settings: A systematic review of quantitative evidence. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0211298"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1007\/s10461-015-1280-y","article-title":"Effects of a Pilot Church-Based Intervention to Reduce HIV Stigma and Promote HIV Testing Among African Americans and Latinos","volume":"20","author":"Derose","year":"2016","journal-title":"AIDS Behav."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1007\/s10461-015-1285-6","article-title":"A Livelihood Intervention to Reduce the Stigma of HIV in Rural Kenya: Longitudinal Qualitative Study","volume":"21","author":"Tsai","year":"2017","journal-title":"AIDS Behav."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1016\/j.socscimed.2009.01.026","article-title":"Media saturation, communication exposure and HIV stigma in Nigeria","volume":"68","author":"Babalola","year":"2009","journal-title":"Soc. Sci. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.4102\/phcfm.v9i1.1314","article-title":"Stigma and discrimination within the Ethiopian health care settings: Views of inpatients living with human immunodeficiency virus and acquired immune deficiency syndrome","volume":"9","author":"Wodajo","year":"2017","journal-title":"Afr. J. Prim. Health Care Fam. Med."},{"key":"ref_33","first-page":"126","article-title":"Experiences of HIV-related stigma among HIV-positive older persons in Uganda\u2014A mixed methods analysis","volume":"11","author":"Kuteesa","year":"2014","journal-title":"SAHARA J J. Soc. Asp. HIV AIDS Res. Alliance"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1097\/QAD.0000000000000495","article-title":"Persistent HIV-related stigma in rural Uganda during a period of increasing HIV incidence despite treatment expansion","volume":"29","author":"Chan","year":"2015","journal-title":"AIDS"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1097\/QAI.0000000000001011","article-title":"HIV stigma trends in the general population during antiretroviral treatment expansion: Analysis of 31 countries in sub-Saharan Africa, 2003\u20132013","volume":"72","author":"Chan","year":"2016","journal-title":"JAIDS J. Acquir. Immune Defic. Syndr."},{"key":"ref_36","unstructured":"(2021, September 02). Burundi: Loi n\u00b0 1\/018 du 12 mai 2005 Portant Protection Juridique des Personnes Infect\u00e9es par le virus de l\u2019immunod\u00e9ficience Humaine et des Personnes Atteintes du Syndrome de l\u2019immunod\u00e9ficience Acquise. Available online: https:\/\/toolkit.hivjusticeworldwide.org\/fr\/resource\/loi-n-1018-du-12-mai-2005-portant-protection-juridique-des-personnes-infectees-par-le-virus-de-limmunodeficience-humaine-et-des-personnes-atteintes-du-syndrome-de-l\/."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual. Res. Psychol."},{"key":"ref_38","first-page":"w14113","article-title":"\u2018An unspoken world of unspoken things\u2019: A study identifying and exploring core beliefs underlying self-stigma among people living with HIV and AIDS in Ireland","volume":"145","author":"France","year":"2015","journal-title":"Swiss. Med. Wkly."},{"key":"ref_39","first-page":"344","article-title":"A comparative analysis of perceived stigma among HIV-positive Ghanaian and African American males","volume":"2","author":"Poku","year":"2005","journal-title":"SAHARA-J J. Soc. Asp. HIV AIDS Res. Alliance"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Arias-Colmenero, T., P\u00e9rez-Morente, M.\u00c1., Ramos-Morcillo, A.J., Capilla-D\u00edaz, C., Ruzafa-Mart\u00ednez, M., and Hueso-Montoro, C. (2020). Experiences and Attitudes of People with HIV\/AIDS: A Systematic Review of Qualitative Studies. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17020639"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1007\/s10461-013-0432-1","article-title":"Experiences of stigma, discrimination, care and support among people living with HIV: A four country study","volume":"17","author":"Neuman","year":"2013","journal-title":"AIDS Behav."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1007\/s10461-009-9593-3","article-title":"From conceptualizing to measuring HIV stigma: A review of HIV stigma mechanism measures","volume":"13","author":"Earnshaw","year":"2009","journal-title":"AIDS Behav."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3815","DOI":"10.1007\/s10461-018-2059-8","article-title":"HIV-Related Stigma, Social Support, and Psychological Distress Among Individuals Initiating ART in Ethiopia","volume":"22","author":"Parcesepe","year":"2018","journal-title":"AIDS Behav."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Chambers, L.A., Rueda, S., Baker, D.N., Wilson, M.G., Deutsch, R., Raeifar, E., Rourke, S.B., and Stigma Review Team (2015). Stigma, HIV and health: A qualitative synthesis. BMC Public Health, 15.","DOI":"10.1186\/s12889-015-2197-0"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1002\/nur.10011","article-title":"Measuring stigma in people with HIV: Psychometric assessment of the HIV stigma scale","volume":"24","author":"Berger","year":"2001","journal-title":"Res. Nurs. Health"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/17\/9300\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:55:37Z","timestamp":1760165737000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/17\/9300"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,3]]},"references-count":45,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["ijerph18179300"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18179300","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,3]]}}}