“In God's Hands”: Qualitative Study of Religion/Spirituality and HIV-Related Intersectional Stigma Among Black Women Living With HIV in Washington, DC

ABSTRACT: Cisgender Black women living with HIV (BWLWH) face significant intersectional stigma, racism, and discrimination, contributing to lower adherence to antiretroviral therapy (ART). Given the role of religion and spirituality in Black communities, we explored their influence on HIV treatment. We conducted semi-structured interviews with 30 BWLWH in Washington, DC ( M age = 52.7, SD = 15.95), living with HIV for an average of 26 years ( SD = 9.72); 33% were virally suppressed. Interviews averaged 52 min and revealed intersectional stigma from multiple sources that negatively affected ART adherence. Despite stigma in religious spaces, many participants relied on spirituality to cope, stay in care, and find meaning in their diagnosis. Our findings highlight spirituality as a vital support for BWLWH. Future interventions should address both intersectional stigma and the protective role of spirituality to improve ART adherence and help reach the goals of Ending the HIV Epidemic.