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Beyond Diagnosis: Structural Stigma, Trauma, and Mental Health Among People Living with HIV in Tunisia: A Narrative Review

Year: 2026
Type: review
Abstract: HIV-related stigma constitutes a critical structural determinant adversely affecting mental health and treatment outcomes among people living with HIV/AIDS (PLWH) in Tunisia. Rooted in cultural conservatism, legal criminalization, and institutional discrimination, stigma engenders social exclusion, trauma, and internalized shame precipitating depression, anxiety, and treatment non-adherence. This narrative review synthesizes recent epidemiological data showing 0.1% general population prevalence but 13% among MSM, with only 26% testing coverage (Primary Health Department Tunisia, 2024) (Hatem). Situated within trauma, social determinants of health, and public health frameworks, this analysis identifies specific challenges for women and older adults living with HIV. Multisectoral strategies integrating healthcare provider training, legal reform, and culturally-tailored mental health services are essential to mitigate stigma's harms and improve equitable health outcomes in Tunisia.
DOI: 10.3390/ijerph23091096
Authors: Hatem Laroussi, Mourad Elghali, Wafa Marrakchi, Intissar Souli, Asma Ben Hassine, Amira Abassi, Foued Trabelsi, Hanen Gundogdu
Institutions: Université Laval, VITAM - Centre de recherche en santé durable, University of Monastir, Hospital Fatuma Bourguiba Monastir, Government of New Brunswick, Tunis El Manar University, California State University, San Marcos
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $3,016
OpenAlex ID: W7204079977
FWCI:
Cites: 24
Cited by:
Related to: 10