Little is known about how people living with HIV in low prevalence contexts face the challenges of stigma and
discrimination. Low prevalence and rural communities are unique environments in which HIV-related stigma
and discrimination may be intensified due to lower tolerance of differences among people and greater fear of
HIV. This study examined the experiences of 16 individuals living with HIV who reside in a predominantly rural
area with low HIV prevalence. We used in-depth interviews to explore participants’ experience with stigma and
discrimination in social and health care settings and their behavioral and emotional responses. In their day-today
lives, participants described feeling social rejection, being forced to follow different rules of social contact,
and being treated differently. In health care settings, participants described specific instances when they felt
providers were afraid of them and when they were refused or discouraged treatment or treated differently based
on their HIV status. Participants experienced stigma and acts of discrimination in different settings (e.g., physician
and dentist offices and hospitals) and from a range of types of providers (e.g., physicians, nurses, and
dentists). Behavioral and emotional responses to perceived acts of stigma and discrimination included anger,
shame, social isolation, and self-advocacy. Findings point to a need to develop tailored interventions to address
stigma and discrimination for individuals, health care personnel and the community-at-large
