Stigma related to weight and body size among women living with and living without HIV: A qualitative study

Abstract

Body changes including weight gain and visceral adiposity are prevalent among women living with HIV and may pose risks for weight stigma–negative attitudes, beliefs, and judgments about a person related to their body size. We undertook a qualitative investigation to describe experiences of weight stigma and to compare and contrast those experiences among women living with and living without HIV. Participants were recruited from Women’s Interagency HIV Study sites in Jackson, MS; Birmingham, AL; and Atlanta GA and invited to participate in an individual phone interview. Interviews were transcribed, coded by two members of the research team, and analyzed using deductive and inductive thematic analysis. Twenty-eight women completed interviews of whom 19 (68 %) were HIV+; 26 (95 %) were Black; with a range of body sizes approximated by BMI (range: 19–40+). Women described community weight stigma as it related to gender, race, HIV status, and age. Enacted weight stigma was pervasive, came from multiple sources, and related to being perceived as too thin or too big. Anticipated and internalized weight stigma were concerns described by women with larger bodies, but not smaller bodies. Women living with HIV expressed worries about abdominal fat accumulation revealing their HIV status. Overall, weight stigma was a common experience among women regardless of HIV status. Women living with HIV are at risk for weight and body changes, introducing opportunities for stigma. Consideration of intersectional stigma related to body size and HIV must be given in any efforts to address weight-related health among women living with HIV.