10th U6+ Consortium of African Universities International Conference

Africa’s Fifth Industrial Revolution (5IR) prioritizes inclusive innovation, citizen engagement, and human-centered development. However, for people living with HIV (PLHIV), persistent stigma continues to limit equitable participation in health systems despite existing legal and policy frameworks. This study examines the gap between anti-stigma policy and lived experience, highlighting implications for inclusive transformation. A mixed-methods cross-sectional study was conducted in Ikot Ekpene, Akwa Ibom State, Nigeria. Quantitative data were collected from 295 PLHIV using structured questionnaires assessing policy awareness, exposure to stigma-reduction interventions, and perceived outcomes. Qualitative data from 30 in-depth interviews and four focus group discussions (n=62) explored lived experiences and systemic barriers. Data were analyzed using descriptive statistics and thematic analysis. Findings revealed low awareness of the HIV/AIDS Anti-Discrimination Act (21.7%) and limited access to legal or advocacy support (4.4%). Participation in community sensitization initiatives was minimal (12.5%), while 72.1% of respondents reported no improvement in stigma over the past five years. Qualitative evidence highlighted weak policy enforcement, tokenistic community engagement, inadequate healthcare worker training, and a critical absence of psychosocial support services. The study demonstrates that anti-stigma policies remain largely symbolic without effective implementation mechanisms. Advancing inclusive innovation in Africa’s 5IR requires translating policy into action through community-driven interventions, strengthened health system capacity, and integrated psychosocial and legal support frameworks. Embedding citizen-centered approaches is essential to achieving equitable and sustainable HIV care.