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

Background: Stigma constitutes a major barrier to effective HIV–tuberculosis (HIV–TB) care among keypopulations experiencing intersecting social and structural vulnerabilities. However, the lived experiencesof stigma among key populations within HIV-TB care remain insufficiently explored. This study aimedto 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 selectedindividuals diagnosed with HIV-TB from key informants in Lampung Province, Indonesia. Theoverall study was conducted from August to November 2025 over four-months. Data were collectedthrough one-time in-depth semi-structured interviews and analyzed manually using Colaizzi’s sevenstepmethod. Recruitment continued until data saturation was achieved, indicated by the absence ofnew 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 toHIV-TB care, reflected in discriminatory health service procedures, fragmented services, andavoidance 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 withHIV-TB and continues to influence engagement with care at individual, interpersonal, and structurallevels. These findings highlight the critical role of nurses and community-based HIV-TB servicesin fostering trust, delivering stigma-sensitive care, and supporting sustained engagement amongmarginalized populations.