Stigma and Social Exclusion Faced by People Living with HIV/AIDS in Enugu State

Social stigma directed at people living with HIV and AIDS continues to undermine treatment adherence, social participation, and psychological wellbeing among affected individuals in Nigeria's South East zone. This study examines the manifestations and drivers of stigma and social exclusion among people living with HIV/AIDS in Enugu State. A mixed-methods design was adopted, with structured questionnaires administered to 200 PLHIV recruited through four antiretroviral treatment centers in Enugu, Oji River, and Igbo-Eze South local government areas, complemented by fifteen in-depth interviews. The Goffman Stigma Theory was applied as the primary framework. Results indicate that enacted stigma, defined as direct discriminatory treatment, was reported by 61% of respondents, manifesting most frequently in family exclusion from shared meals, disclosure of HIV status by others without consent, and social withdrawal by former friends. Anticipated stigma led 48% of respondents to conceal their HIV status from all but one or two trusted individuals, limiting their social support networks. Workplace discrimination had caused job loss in 23% of employed respondents following HIV status disclosure. Women experienced higher stigma intensity than men across all domains, reflecting the intersection of gender inequality with HIV stigma. Treatment adherence was significantly lower among respondents with high stigma scores. Support group membership was the strongest mediating factor reducing stigma's impact on wellbeing and adherence. Recommendations include mandatory HIV stigma training for healthcare and workplace settings in Enugu, support group infrastructure investment, and public awareness campaigns leveraging trusted community voices. Keywords: HIV/AIDS stigma, social exclusion, Enugu State, PLHIV, discrimination.