Research-based narrative videos to reduce stigma: insights from older women living with HIV.

Introduction: Older women living with HIV (WLWH) experience a heightened burden of stigma, compounded by age, gender, social isolation, and depression. Despite growing recognition of these challenges, few stigma reduction interventions are specifically designed for this population, particularly in the Southern United States. Methods: We explored the acceptability, personal relevance, and perceived effectiveness of a stigma reduction video series tailored for older WLWH. The videos were developed based on findings from a prior qualitative metasynthesis and reflected the lifecycle of stigma across key themes. A single in-person focus group with 18 older WLWH was conducted at an HIV service organization in the Southern U.S. Participants viewed the videos and provided feedback through structured discussions. Qualitative descriptive analysis and thematic analysis were used to identify key themes. Results: Participants, predominantly African American/Black women with a mean age of 59 years and an average of 24 years since HIV diagnosis, responded positively to the videos. Four major themes emerged: (1) resurfacing memories of early HIV-related stigma; (2) the persistence of internal and perceived stigma; (3) growth, acceptance, and advocacy with aging; and (4) preferences for video format and content, including a desire for more dynamic visuals, expanded educational material, and representations of the full journey of living with HIV from diagnosis to long-term survivorship. Discussion: Brief, narrative-driven videos rooted in lived experiences show promise as a stigma reduction strategy for WLWH. Future interventions should incorporate multigenerational perspectives, expand educational content, and leverage visually engaging formats to enhance relevance and impact.