As a social determinant of health, stigma is a major barrier to health care access, illness management and completing the treatment. It is attributed both to HIV as a health condition and to the populations at risk of being infected with it. In Serbia, HIV is associated with men who have sex with men (MSM), with a noticeable stigma towards them. Drawing upon a qualitative cross-sectional study, conducted in three Serbian cities, we explore the MSM’s perception of HIV in the context of that social stigma. Using a respondent-driven sampling approach, 62 targeted MSM respondents participated in focus groups discussions and in-depth interviews. We found that the participants’ understandings of the HIV infection, risks and prevention are shaped by stigma. Those MSM who resisted stigma relativised the HIV risk, associating it with the general population and HIV-positive MSMs, believing that HIV, perceived as a chronical illness, was unjustly related to MSM. As one of the main preventive measures, serosorting was based on alleged HIV-positive statuses of potential sexual partners. HIV-negative participants described perceiving HIV-positive MSM as the ones responsible for spreading the virus, since they were concealing their positive status. As a response to stigma, MSM tended to challenge the HIV discourse, shifting it away from MSM onto the general (male) population and HIV positive MSM. Our analysis suggests that stigma resistance may make MSM more susceptible to taking risks. HIV prevention programmes should take the social context of MSM into account and target MSM-related stigma.

作为健康的社会决定因素，污名是获得医疗保健，疾病管理和完成治疗的主要障碍。它既归因于艾滋病毒的健康状况，又归因于有感染艾滋病毒风险的人群。在塞尔维亚，艾滋病毒与与男性发生性关系的男性有关，对男性的污名明显。根据在三个塞尔维亚城市进行的定性横断面研究，我们在这种社会污名的背景下探讨了MSM对艾滋病的看法。使用受访者驱动的抽样方法，有62位目标MSM受访者参加了焦点小组讨论和深入访谈。我们发现，参与者对艾滋病毒感染，风险和预防的理解受到污名的影响。那些抵制污名的男男性接触者将艾滋病毒的风险相对化，将其与一般人群和HIV阳性MSM相关联，认为被认为是慢性病的HIV与MSM不合理相关。作为主要的预防措施之一，血清分选是基于所谓的潜在性伴侣的HIV阳性状态。HIV阴性参与者描述为认为HIV阳性MSM是造成病毒传播的原因，因为他们隐瞒了自己的阳性状态。作为对耻辱的回应，MSM倾向于挑战HIV话语，将其从MSM转移到普通（男性）人群和HIV阳性MSM。我们的分析表明，抗污名性可能使MSM更容易冒险。艾滋病毒预防计划应考虑男男性接触者的社会背景，并针对与男男性接触者相关的污名。被认为是一种慢性疾病，与MSM不合理相关。作为主要的预防措施之一，血清分选是基于所谓的潜在性伴侣的HIV阳性状态。HIV阴性参与者描述为认为HIV阳性MSM是造成病毒传播的原因，因为他们隐瞒了自己的阳性状态。作为对耻辱的回应，MSM倾向于挑战HIV话语，将其从MSM转移到普通（男性）人群和HIV阳性MSM。我们的分析表明，抗污名性可能使MSM更容易冒险。艾滋病毒预防计划应考虑男男性接触者的社会背景，并针对与男男性接触者相关的污名。被认为是一种慢性疾病，与MSM不合理相关。作为主要的预防措施之一，血清分选是基于所谓的潜在性伴侣的HIV阳性状态。HIV阴性参与者描述为认为HIV阳性MSM是造成病毒传播的原因，因为他们隐瞒了自己的阳性状态。作为对耻辱的回应，MSM倾向于挑战HIV话语，将其从MSM转移到普通（男性）人群和HIV阳性MSM。我们的分析表明，抗污名性可能使MSM更容易冒险。艾滋病毒预防计划应考虑男男性接触者的社会背景，并针对与男男性接触者相关的污名。HIV阴性参与者描述为认为HIV阳性MSM是造成病毒传播的原因，因为他们隐瞒了自己的阳性状态。作为对耻辱的回应，MSM倾向于挑战HIV话语，将其从MSM转移到普通（男性）人群和HIV阳性MSM。我们的分析表明，抗污名性可能使MSM更容易冒险。艾滋病毒预防计划应考虑男男性接触者的社会背景，并针对与男男性接触者相关的污名。HIV阴性参与者描述为认为HIV阳性MSM是造成病毒传播的原因，因为他们隐瞒了自己的阳性状态。作为对耻辱的回应，MSM倾向于挑战HIV话语，将其从MSM转移到普通（男性）人群和HIV阳性MSM。我们的分析表明，抗污名性可能使MSM更容易冒险。艾滋病毒预防计划应考虑男男性接触者的社会背景，并针对与男男性接触者相关的污名。我们的分析表明，抗污名性可能使MSM更容易冒险。艾滋病毒预防计划应考虑男男性接触者的社会背景，并针对与男男性接触者相关的污名。我们的分析表明，抗污名性可能使MSM更容易冒险。艾滋病毒预防计划应考虑男男性接触者的社会背景，并针对与男男性接触者相关的污名。