Abstract
INTRODUCTION: Despite progress in HIV treatment and prevention, stigma and discrimination remain significant barriers to the health and well-being of people living with HIV/AIDS (PLWHA), particularly in sub-Saharan Africa. In Ghana's Sunyani Municipality, where HIV prevalence is notably high, PLWHA continue to face social, emotional and systemic challenges that undermine their quality of life and treatment adherence. This study explored the lived experiences of PLWHA in Sunyani Municipality, focusing on the drivers, manifestations and impacts of HIV-related stigma and discrimination. METHODS: A qualitative descriptive phenomenological approach was employed, involving in-depth interviews with 15 purposively sampled participants living with HIV/AIDS from two public healthcare facilities. Data were analysed thematically using Braun and Clarke's framework, with NVivo software supporting coding and theme development. RESULTS: Six main themes and multiple subthemes emerged: (1) drivers of stigma, referring to underlying beliefs and perceptions that give rise to HIV-related stigma, including lack of knowledge, fear of infection and social judgement; (2) sociocultural and structural facilitators of stigma, describing contextual conditions that enable and reinforce stigmatising attitudes and behaviours, such as prevailing sociocultural norms and prejudice; (3) direct experiences of maltreatment and rejection; (4) challenges faced by affected individuals, including fear of disclosure, emotional distress and economic hardship; (5) negative effects of stigma, such as treatment interruption, social isolation and thoughts of self-harm and (6) coping and mitigation strategies, including public education, spiritual support, family involvement and calls for legal and policy reforms. Comparisons with global studies revealed broadly similar patterns; however, the persistence of misinformation and the limited availability of integrated mental health support were particularly pronounced in the Ghanaian context. CONCLUSIONS: Stigma and discrimination remain embedded in the social and healthcare environments of PLWHA in Sunyani, with serious implications for treatment adherence and mental well-being. Addressing these issues requires multifaceted interventions, including community education, healthcare provider training, psychosocial and spiritual support, and legal enforcement to create a more inclusive and supportive environment.