Perceived HIV-related stigma among people living with HIV in Guinea: findings from the ASSIST study

HIV-related stigma remains a barrier to healthcare access and adherence. In sub-Saharan Africa, it leads to delayed testing, poor care retention, and psychosocial issues. Guinea has a high HIV stigma index, yet limited research examines its impact on PLWH. This study assesses factors influencing perceived stigma to intervention efforts. This study was conducted in four DREAM centers in Guinea from November 2023 to June 2024. PLWH aged ≥18 receiving care were enrolled through convenience sampling. Data were collected via a structured questionnaire on demographics, treatment adherence, and stigma experiences. Descriptive statistics and univariate regression analyzed associations with stigma scores. 402 PLWH participated, 81.6% female, median age 32 years (IQR: 27-40). 55% didn't disclose their HIV status to family, and 43% experienced social isolation. Emotional distress following diagnosis was common, with 35.6% reporting intense crying and 21.6% expressing despair. Male participants (β = -0.70 [-1.2,-0.22], p = 0.004), older individuals (β = -0.02 [-0.04,0.00] p = 0.016), and those with greater trust in HIV treatment (β = -2.1 [-2.7, - 1.5] p < 0.001) had significantly lower stigma scores. HIV stigma in Guinea affects relationships, mental health, and care adherence. Trust in ART helps reduce stigma. Stigma-reduction efforts should focus on communication, peer support, and policy changes.