{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T02:00:29Z","timestamp":1792720829039,"version":"4.5.0"},"reference-count":54,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"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>Background: The experiences in coping with HIV\/AIDS from people living with HIV (PLWH) in Austria, Munich, and Berlin regarding adherence, antiretroviral therapy (ART), stigmatization, and discrimination were the main focus of this study. Therapy adherence is the cornerstone for PLWH to reduce disease progression and increase life expectancy combined with a high quality of life. The experience of stigmatization and discrimination in different life situations and settings is still experienced today. Aims: We aimed to examine the subjective perspective of PLWH concerning living with, coping with, and managing HIV\/AIDS in daily life. Methods: Grounded Theory Methodology (GTM) was used. Data collection was conducted with semi-structured face-to-face interviews with 25 participants. Data analysis was performed in three steps, open, axial, and selective coding. Results: Five categories emerged, which included the following: (1) fast coping with diagnosis, (2) psychosocial burden due to HIV, (3) ART as a necessity, (4) building trust in HIV disclosure, (5) stigmatization and discrimination are still existing. Conclusion: In conclusion, it can be said that it is not the disease itself that causes the greatest stress, but the process of coping with the diagnosis. Therapy, as well as lifelong adherence, is hardly worth mentioning today. Much more significant is currently still the burden of discrimination and stigmatization.<\/jats:p>","DOI":"10.3390\/ijerph20043000","type":"journal-article","created":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T01:59:43Z","timestamp":1675907983000},"page":"3000","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["People Living with HIV and AIDS: Experiences towards Antiretroviral Therapy, Paradigm Changes, Coping, Stigma, and Discrimination\u2014A Grounded Theory Study"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0166-2455","authenticated-orcid":false,"given":"Helmut","family":"Beichler","sequence":"first","affiliation":[{"name":"Nursing School, General Hospital, Medical University Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Kutalek","sequence":"additional","affiliation":[{"name":"Centre for Public Health, Department of Social and Preventive, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5218-1160","authenticated-orcid":false,"given":"Thomas E.","family":"Dorner","sequence":"additional","affiliation":[{"name":"Academy for Ageing Research, Haus der Barmherzigkeit, 1160 Vienna, Austria"},{"name":"Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15\/1, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3004","DOI":"10.1093\/jac\/dkaa246","article-title":"Effectiveness and safety of first-line antiretroviral regimens in clinical practice: A multicenter cohort study","volume":"75","author":"Alejos","year":"2020","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Armoon, B., Higgs, P., Fleury, M.-J., Bayat, A.-H., Moghaddam, L.F., Bayani, A., and Fakhri, Y. (2021). Socio-demographic, clinical and service use determinants associated with HIV related stigma among people living with HIV\/AIDS: A systematic review and meta-analysis. BMC Health Serv. Res., 21.","DOI":"10.1186\/s12913-021-06980-6"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12981-022-00452-5","article-title":"Patient experiences and preferences for antiretroviral therapy service provision: Implications for differentiated service delivery in Northwest Ethiopia","volume":"19","author":"Belay","year":"2022","journal-title":"AIDS Res. Ther."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1007\/s15010-020-01428-1","article-title":"High effectiveness of recommended first-line antiretroviral therapies in Germany: A nationwide, prospective cohort study","volume":"48","author":"Bickel","year":"2020","journal-title":"Infection"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1007\/s10461-007-9231-x","article-title":"HIV-Related Stigma among People with HIV and their Families: A Qualitative Analysis","volume":"12","author":"Bogart","year":"2008","journal-title":"AIDS Behav."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1007\/s10461-018-2234-y","article-title":"A Pilot Intervention Trial to Promote Sexual Health and Stress Management among HIV-Infected Men Who Have Sex with Men","volume":"23","author":"Brown","year":"2019","journal-title":"AIDS Behav."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1007\/s10461-021-03496-2","article-title":"Patient Health Literacy and Communication with Providers among Women Living with HIV: A Mixed Methods Study","volume":"26","author":"Budhwani","year":"2022","journal-title":"AIDS Behav."},{"key":"ref_8","unstructured":"Center for Disease Control and Prevention CDC (2022, July 07). Protecting Others, Available online: https:\/\/www.cdc.gov\/hiv\/basics\/livingwithhiv\/protecting-others.html."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1007\/s10461-020-02990-3","article-title":"Awareness and Acceptability of Undetectable = Untransmittable among a U.S. National Sample of HIV-Negative Sexual and Gender Minorities","volume":"25","author":"Carneiro","year":"2021","journal-title":"AIDS Behav."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3688","DOI":"10.1007\/s10461-022-03697-3","article-title":"Posttraumatic Growth and Posttraumatic Stress Symptoms in People with HIV","volume":"26","author":"Chi","year":"2022","journal-title":"AIDS Behav."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/BF00988593","article-title":"Grounded theory research: Procedures, canons and evaluative criteria","volume":"13","author":"Corbin","year":"1996","journal-title":"Qual. Sociol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1007\/s10461-016-1541-4","article-title":"Non-Disclosure of HIV Status and Association with Psychological Factors, ART Non-Adherence, and Viral Load Non-Suppression among People Living with HIV in the UK","volume":"21","author":"Daskalopoulou","year":"2017","journal-title":"AIDS Behav."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.jana.2016.03.001","article-title":"Building Trust and Relationship between Patients and Providers: An Essential Complement to Health Literacy in HIV Care","volume":"27","author":"Cucac","year":"2016","journal-title":"J. Assoc. Nurses AIDS Care"},{"key":"ref_14","unstructured":"European Centre for Disease Prevention and Control\/WHO (2022, March 03). HIV\/AIDS Surveillance in Europe 2017\u20132016 Data, Available online: https:\/\/ecdc.europa.eu\/sites\/portal\/files\/documents\/20171127-Annual_HIV_Report_Cover%2BInner.pdf."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10461-016-1453-3","article-title":"HIV Disclosure Anxiety: A Systematic Review and Theoretical Synthesis","volume":"21","author":"Evangeli","year":"2017","journal-title":"AIDS Behav."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1056\/NEJMp1916753","article-title":"Four Decades of HIV\/AIDS\u2014Much Accomplished, Much to Do","volume":"383","author":"Fauci","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"100112","DOI":"10.1016\/j.ssmqr.2022.100112","article-title":"Understanding stigma and suicidality among gay men living with HIV: A photovoice project","volume":"2","author":"Ferlatte","year":"2022","journal-title":"SSM\u2014Qual. Res. Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.jana.2016.08.010","article-title":"Patient\u2019s Perceptions and Experiences of Shared Decision-Making in Primary HIV Care Clinics","volume":"28","author":"Fuller","year":"2017","journal-title":"J. Assoc. Nurses AIDS Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/s10461-019-02478-9","article-title":"Self-Disclosure of HIV Status among Youth Living with HIV: A Global Systematic Review","volume":"24","author":"Gabbidon","year":"2020","journal-title":"AIDS Behav."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Ghiasvand, H., Waye, K.M., Noroozi, M., Harouni, G.G., Armoon, B., and Bayani, A. (2019). Clinical determinants associated with quality of life for people who live with HIV\/AIDS: A Meta-analysis. BMC Health Serv. Res., 19.","DOI":"10.1186\/s12913-019-4659-z"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Glaser, B.G., and Strauss, A.L. (1967). The Discovery of Grounded Theory. Strategies for Qualitative Research, Aldine.","DOI":"10.1097\/00006199-196807000-00014"},{"key":"ref_22","unstructured":"Goffman, E. (1979). Stigma: \u00dcber Techniken der Bew\u00e4ltigung Besch\u00e4digter Identit\u00e4t, Suhrkamp. [3rd ed.]."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s10461-021-03260-6","article-title":"HIV-related Stigma Research as a Priority at the National Institute of Health","volume":"26","author":"Greenwood","year":"2022","journal-title":"AIDS Behav."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1880","DOI":"10.1007\/s10461-021-03539-8","article-title":"The Effect of Initial Patient Experiences and Life Stressors on Predicting Lost to Follow-Up in Patients New to an HIV Clinic","volume":"26","author":"Guajardo","year":"2022","journal-title":"AIDS Behav."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2600","DOI":"10.1007\/s10461-019-02614-5","article-title":"\u201cYou Take Medications, You Live Normally\u201d: The Role of Antiretroviral Therapy in Mitigating Men\u2019s Perceived Threats of HIV in Cote d\u2019Ivoire","volume":"23","author":"Hendrickson","year":"2019","journal-title":"AIDS Behav."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3836","DOI":"10.1007\/s10461-018-2066-9","article-title":"The Impact of Quality Assurance Initiatives and Workplace Policies and Procedures on HIV\/AIDS-Related Stigma Experienced by Patients and Nurses in Regions with High Prevalence of HIV\/AIDS","volume":"22","author":"Hewko","year":"2018","journal-title":"AIDS Behav."},{"key":"ref_27","unstructured":"Hoffmann, C., and Rockstroh, J. (2023, February 02). HIV Buch. Available online: https:\/\/www.hivbuch.de\/wp-content\/uploads\/2020\/11\/HIV2020-21-1.pdf."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s10461-005-1684-1","article-title":"Patient-Clinician Relationship and Treatment System Effects on HIV Medication Adherence","volume":"9","author":"Ingersoll","year":"2005","journal-title":"AIDS Behav."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1007\/s10461-018-2265-4","article-title":"The Role of Gender in Patient-Provider Relationships: A Qualitative Analysis of HIV Care Providers in Western Kenya with Implications for Retention in Care","volume":"23","author":"Knight","year":"2019","journal-title":"AIDS Behav."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1046\/j.1525-1497.2000.90732.x","article-title":"Taking Antiretroviral Therapy for HIV Infection. Learning from Patients\u2019 Stories","volume":"15","author":"Laws","year":"2000","journal-title":"J. Gen. Intern. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1016\/S0140-6736(06)68184-1","article-title":"Stigma and its public health implication","volume":"367","author":"Link","year":"2006","journal-title":"Lancet"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1089\/apc.2013.0306","article-title":"Stigma, Disclosure, Coping, and Medication Adherence among People Living with HIV\/AIDS in Northern Tanzania","volume":"28","author":"Lyimo","year":"2014","journal-title":"AIDS Patient Care STDs"},{"key":"ref_33","first-page":"1475","article-title":"The Lived Experience of Women with HIV\/AIDS: A Qualitative Study","volume":"11","author":"Marni","year":"2016","journal-title":"Int. J. Caring Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1080\/09540121.2019.1679707","article-title":"Experiences with stigma and discriminiation among adolescents and young adults living with HIV in Bangkok, Thailand","volume":"32","author":"Mathew","year":"2020","journal-title":"AIDS Care"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2942","DOI":"10.1007\/s10461-020-02845-x","article-title":"A Scoping Review of Employment and HIV","volume":"24","author":"Maulsby","year":"2020","journal-title":"AIDS Behav."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"S65","DOI":"10.1016\/j.drugalcdep.2013.06.034","article-title":"Antiretroviral therapy for prevention of HIV transmission: Potential role for people who inject drugs in Central Asia","volume":"132","author":"McNairy","year":"2013","journal-title":"Drug Alcohol Depend."},{"key":"ref_37","first-page":"8","article-title":"Nurses\u2019 implementation of mental health screeing among HIV infected guidelines","volume":"8","author":"Modula","year":"2018","journal-title":"Int. J. Afr. Nurs. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2084","DOI":"10.1007\/s10461-020-03137-0","article-title":"Association of experienced and internalized stigma with self-disclosure of HIV status by youth living with HIV","volume":"25","author":"Mugo","year":"2021","journal-title":"AIDS Behav."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s12955-021-01702-2","article-title":"Health-related quality of life of people living with HIV\/AIDS: The role of social inequalities and disease-related factors","volume":"19","author":"Nigusso","year":"2021","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3538","DOI":"10.1007\/s10461-021-03362-1","article-title":"Predictors of HIV Status Disclosure to Sexual Partners among People Living with HIV in Brazil","volume":"25","author":"Reis","year":"2021","journal-title":"AIDS Behav."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1023\/A:1022513507669","article-title":"Adherence to Medication Treatment: A Qualitative Study of Facilitators and Barriers among a Diverse Sample of HIV+ Men and Women in Four U.S. Cities","volume":"7","author":"Remien","year":"2003","journal-title":"AIDS Behav."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Rintamaki, L., Kosenko, K., Hogan, T., Scott, A.M., Dobmeier, C., Tingue, E., and Peek, D. (2019). The Role of Stigma Management in HIV Treatment Adherence. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16245003"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1080\/09540121.2018.1441969","article-title":"Association between coping strategies, social support, and depression and anxiety symptoms among rural Ugandan women living with HIV\/AIDS","volume":"30","author":"Seffren","year":"2018","journal-title":"AIDS Care"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1016\/j.socscimed.2007.01.006","article-title":"Inernalized stigma, discrimination, depression among men and women living with HIV\/AIDS in Cape Town, South Africa","volume":"64","author":"Simbayi","year":"2007","journal-title":"Soc. Sci. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1007\/s10461-016-1323-z","article-title":"Taking into Account the Quality of the Relationship in HIV Disclosure","volume":"21","author":"Smith","year":"2017","journal-title":"AIDS Behav."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3400","DOI":"10.1007\/s10461-022-03683-9","article-title":"Stigmatizing Policies Interact with Mental Health and Sexual Behaviours to Structurally Induce HIV Diagnose among European Men Who Have Sex with Men","volume":"26","author":"Stojanovski","year":"2022","journal-title":"AIDS Behav."},{"key":"ref_47","unstructured":"Strauss, A.L., and Corbin, J. (1996). Grounded Theory: Grundlagen Qualitativer Sozialforschung, Beltz."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s10461-015-1164-1","article-title":"The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature","volume":"20","author":"Sweeny","year":"2016","journal-title":"AIDS Behav."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s10461-008-9374-4","article-title":"A Qualitative Study of Stigma and Discrimination against People Living with HIV in Ho Chi Minh City, Vietnam","volume":"12","author":"Thi","year":"2008","journal-title":"AIDS Behav."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1007\/s10461-010-9667-2","article-title":"Work-related Barriers and Facilitators to Antiretroviral Therapy Adherence in Persons Living with HIV-Infection","volume":"15","author":"Lerner","year":"2011","journal-title":"AIDS Behav."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s10461-016-1451-5","article-title":"How Does Stigma Affect People Living with HIV? The Mediating Roles of Internalized and Anticipated HIV Stigma in the Effects of Perceived Community Stigma on Health and Psychosocial Outcomes","volume":"21","author":"Turan","year":"2017","journal-title":"AIDS Behav."},{"key":"ref_52","unstructured":"(2022, August 14). UNAIDS. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/UNAIDS_FactSheet_en.pdf."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.ijmedinf.2016.04.013","article-title":"Information and communication Technologies for adherence to antiretroviral treatment in adults with HIV\/AIDS","volume":"92","author":"Galvao","year":"2016","journal-title":"Int. J. Med. Inform."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1007\/s10461-014-0701-7","article-title":"Coping Strategies for HIV-Related Stigma in Liuzhou, China","volume":"18","author":"Zhang","year":"2014","journal-title":"AIDS Behav."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/4\/3000\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:27:44Z","timestamp":1760120864000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/4\/3000"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,9]]},"references-count":54,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["ijerph20043000"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20043000","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,9]]}}}