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

Background: 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. Methods: 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. Results: 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. Conclusion: 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.