Community-Level HIV Stigma and Projected Quality of Life: A Cross-Sectional Evaluation of Societal Stereotyping in a Malaysian University

Abstract Background HIV-related stigma remains a formidable public health barrier, compromising the social integration, treatment adherence, and psychological well-being of people living with HIV (PLHIV). While actual Health-Related Quality of Life (HRQoL) among PLHIV is well-documented, public assumptions and stereotypes regarding the lived experiences of PLHIV are rarely quantified. This study evaluated community-level HIV stigma and the public’s projected HRQoL for PLHIV within a university campus in Malaysia. Methods A cross-sectional survey was conducted among university students and employees at the International Islamic University Malaysia (IIUM) Centre for Natural and Health Sciences (CNHS). Data were collected using the validated HIV Stigma Questionnaire, which evaluates six conceptual domains: anticipated stigma, fear of infection, discrimination, perceived stigma, social judgement, and experienced stigma. Concurrently, respondents completed the WHOQOL-HIV BREF from the imagined perspective of PLHIV to assess empathic projection. Chi-square tests of independence assessed associations between sociodemographic characteristics and stigma domains, while descriptive statistics evaluated the transformed QoL domain scores. Results 406 respondents showed high levels of community stigmatization, with anticipated stigma emerging as the most prevalent domain (91.9%, n = 373) followed by fear of infection (83.5%, n = 339). Gender was significantly associated with social judgement ( p = 0.001), experienced stigma ( p = 0.005), and discrimination ( p < 0.01). Employment status showed significant associations with social judgement ( p < 0.001), whereas general educational qualification yielded no statistically significant impact on stigma reduction. Projected WHOQOL-HIV BREF scores were strikingly depressed across all dimensions. Respondents estimated the lowest QoL in the Spirituality, Religion and Personal Beliefs domain (Mean = 33.5 ± 23.3 out of 100), followed by the Psychological domain (Mean = 45.4 ± 22.9). Conclusion HIV-related stigma remains highly prevalent within higher education communities, driven primarily by persistent transmission fears and moral judgment rather than a lack of general academic attainment. The severely depressed projected QoL scores, particularly within the spiritual domain, highlight a pervasive community stereotype that HIV inevitably destroys an individual's spiritual peace and psychological stability. Public health interventions must transcend biological education, combining health literacy with faith-aligned community engagement to challenge moral stereotypes and foster social pardoning of PLHIV.