Once HIV Knowledge Is Addressed: HIV-Stigma From the Perspective of Healthcare Professionals Working in HIV Facilities.

Objectives: Stigmatising behaviour towards people with HIV (PWH) by healthcare professionals (HCPs) are often linked to poor HIV knowledge. This qualitative study explores how HIV-related stigma affects daily practice when HIV knowledge is high. Methods: HCPs from HIV care facilities in French-speaking Switzerland-administrative staff, nurses, and physicians-were invited to be interviewed by a team trained in qualitative methods using semi-structured guides. Interview transcripts were analysed with IRaMuTeQ software. Results: Ten interviews were completed before data saturation was reached. Three themes emerged: 1) clinic reception, 2) care provision for PWH, and 3) HIV knowledge. Administrative staff described challenges in maintaining patient anonymity. These included not greeting people by name and organising appointment schedules so people from shared social groups never meet at the clinic, thus avoiding HIV-status-sharing by inference. Physicians described underestimating stigma experienced by PWH and cited time constraints during consultations to address this. All groups felt that stigma persists due to limited HIV knowledge among the general public and non-specialist HCPs. Conclusion: Even with good HIV knowledge, HIV-stigma impacts HCP practice and care provision. Efforts to protect anonymity may unintentionally reinforce rather than address HIV-stigma. While improving public and HCP HIV knowledge reduces enacted HIV-stigma, collaborative interventions between HCP sectors and with PWH could help to adapt HCP practices.