Unpacking the "Backpack of Shame": Exploring Intersections of Stigma Among Latinx People Living With HIV in San Francisco, CA

Objective: Ending the HIV epidemic requires addressing structural determinants of health, including stigma. In this qualitative study, we applied an intersectional framework to study various forms of stigma among Latinx people living with HIV (PLWH). Method: We conducted focus groups and individual interviews with Spanish- and English-speaking Latinx PLWH (N = 19) at an HIV safety-net clinic in San Francisco, California. Using thematic analysis, we identified co-occurring forms of stigma impacting the participants' lives. Results: Participants described the weight of co-occuring stigma related to their multiple identities, including homophobia and HIV-related stigma, both of which participants experienced in the U.S. and in their Latin American home countries. Importantly, many participants faced anti-immigrant stigma in their day-to-day interactions, which manifested as structural inequities such as difficulty finding stable housing and employment. Conclusions: Our findings illustrate experiences of intersectional stigma and systems of oppression. They can be used to inform policies that address social exclusion, discrimination, and stigma among Latinx PLWH.