International Journal of Community Based Nursing & Midwifery

International Journal of Community Based Nursing & Midwifery

Lived Experience of Stigma among People Living with HIV-tuberculosis Co-infection: A Phenomenological Study

Document Type : Original Article

Authors
Agung Waluyo 1
Ikhwan Amirudin 2
M Agung Akbar 3
Astuti Yuni Nursasi 3
Nor Aziyan Binti Yahaya 4
Untung Sujianto 5
1 Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Indonesia;
2 Department of Nursing, Faculty of Health, Universitas Aisyah Pringsewu, Indonesia;
3 Department of Community Health Nursing, Faculty of Nursing, Universitas Indonesia, Indonesia;
4 Department of Nursing Science, Faculty of Nursing, Universiti Malaya, Malaysia;
5 Department of Nursing, Faculty of Medicine, Universitas Diponegoro, Indonesia
10.30476/ijcbnm.2026.110638.3027
Abstract
Background: Stigma constitutes a major barrier to effective HIV–tuberculosis (HIV–TB) care among key
populations experiencing intersecting social and structural vulnerabilities. However, the lived experiences
of stigma among key populations within HIV-TB care remain insufficiently explored. This study aimed
to explore the lived experiences of stigma among people living with HIV-TB co-infection in Indonesia.
Methods: A descriptive phenomenological study was conducted among 16 purposively selected
individuals diagnosed with HIV-TB from key informants in Lampung Province, Indonesia. The
overall study was conducted from August to November 2025 over four-months. Data were collected
through one-time in-depth semi-structured interviews and analyzed manually using Colaizzi’s sevenstep
method. Recruitment continued until data saturation was achieved, indicated by the absence of
new themes in successive interviews.
Results: The analysis identified 11 subthemes that were further organized into 3 overarching themes:
(1) multidimensional stigma surrounding patients with HIV-TB, encompassing internalized stigma,
family and community stigma, anticipated stigma, and moral judgment; (2) stigma as a barrier to
HIV-TB care, reflected in discriminatory health service procedures, fragmented services, and
avoidance of care; and (3) psychosocial resilience and adaptive coping among patients with HIV-TB,
including emotional resilience, peer support, selective disclosure, and meaning-making.
Conclusion: Stigma remains deeply embedded in the everyday experiences of people living with
HIV-TB and continues to influence engagement with care at individual, interpersonal, and structural
levels. These findings highlight the critical role of nurses and community-based HIV-TB services
in fostering trust, delivering stigma-sensitive care, and supporting sustained engagement among
marginalized populations.

Highlights

Agung Waluyo (Google Scholar) (PubMed)

Keywords
HIV
Social Stigma
Tuberculosis
Vulnerable Populations
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