HIV-related stigma and discrimination refers to prejudice, negative attitudes, abuse and maltreatment directed at people living with HIV and Advance HIV infection. They can result in being shunned by family, peers and the wider community; poor treatment in healthcare and education settings; an erosion of rights; psychological damage; and can negatively affect the success of HIV testing and treatment.

HIV is conceived as a disease that combines stigma elements of perceived contagion and socially undesirable behaviors. Drawing on in-depth interviews with professional adolescent service providers found HIV stigma and stigma management in the lives of HIV-positive young people. The conversations elucidate how additional layers of stigma relating to ‘adolescent rights’ and ‘embodied innocence’ are added to HIV stigma as it is more usually conceived. This study suggests that managing this stigma entails managing silence in the context of the social worlds of the young person, the family and the service provider. Silence emerged as a key theme in the participant narratives and was embedded in the descriptions of young people’s lived experiences. Crucially, silence is a product of oppression and inequity but is also a tool for resistance. Silence defends secrets and exists in the spaces, both physical and social, that are created for them in order to manage the stigma in young people’s lives. Silences associated with HIV therefore need to be exposed if we are to better understand what HIV truly means to seropositive young people and how ‘silences’ may minimize or exacerbate their experience of HIV stigma inside and outside the context of programs.