HIV-Related Stigma, Screening, and Care Engagement Among Youth and Young Adults Aged 15–34 in Cagayan de Oro City: A Mixed-Methods Study

HIV-related stigma remains a significant public health concern that may discourage young people from accessing HIV screening and care despite the availability of prevention, testing, and treatment services in the Philippines. Understanding the different dimensions of stigma and their relationship with HIV testing is important for developing context-specific responses. This study aimed to determine the levels of HIV-related stigma among youth and young adults in selected barangays of Cagayan de Oro City, examine its association with reported HIV testing behavior and comfort toward HIV testing, and explore the experiences of people living with HIV (PLHIV) regarding stigma, discrimination, disclosure, healthcare access, and care. This study employed a convergent mixed-methods design integrating quantitative and qualitative approaches. Quantitative data were collected from 384 youth and young adults aged 15–34 years selected through stratified proportional sampling from six selected barangays in Cagayan de Oro City using a researcher-modified 46-item HIV Stigma and Care Engagement Scale. Descriptive statistics and Pearson correlation were used to analyze the quantitative data. Qualitative data were obtained from seven PLHIV participants through two face-to-face semi-structured interviews and five self-administered written responses using the same semi-structured guide and were analyzed using thematic analysis. Quantitative and qualitative findings were integrated during interpretation. Respondents reported low levels of self-anticipated HIV stigma and moderate levels of interpersonal, institutional, and disclosure-related HIV stigma. HIV-related stigma showed a moderate negative correlation with reported HIV testing behavior (r = −0.41, p < .001) and comfort toward HIV testing (r = −0.36, p < .001). Qualitative analysis generated four interconnected themes: (1) stigma, fear, and concealment in the lived experience of HIV; (2) rights awareness, social support, and the reconstruction of self-worth; (3) structural barriers and mental health needs in HIV care; and (4) advocacy and hope amid persistent stigma. The PLHIV participants described fear of judgment, disclosure concerns, confidentiality issues, structural barriers, and emotional challenges, while also describing supportive relationships, respectful healthcare, rights awareness, advocacy, and hope. Overall, HIV-related stigma in the selected barangays was more evident in interpersonal, institutional, and disclosure-related concerns than in self-anticipated stigma. Higher reported stigma was associated with lower reported HIV testing behavior and comfort toward HIV testing; however, the cross-sectional design does not establish causation. The findings may inform locally appropriate, confidential, and youth-friendly HIV services, stigma-sensitive healthcare, rights and HIV education, and appropriate psychosocial support within the selected communities of Cagayan de Oro City.