Issues related to HIV stigma in Nepal

We conducted a qualitative study to understand and describe experiences of people living with HIV and AIDS with regard to HIV-associated stigma in Nepal. The study has revealed four key themes associated with HIV stigma: a hierarchy of stigma (sexual transmission and women stigmatized more than injecting-drug transmission and men); exclusion and rejection (denial of care services, rejection from family); death as a form of punishment (untimely death is seen as a punishment for something done wrong in the past); and Mumbaiya disease (caught from working in "other places"). Cultural contexts are the best ways to understand HIV stigma in Nepal along with socially and culturally established gender roles. This study has confirmed that stigma manifests at different levels: individual, social, and structural, with denial and rejection being a key mechanism of stigma.