by Kaila Witkowski and Stephen R. Neely
New research highlights the subtle but persistent role of stigma in shaping public support for welfare benefits.
Public support for welfare benefits often hinges on perceptions of who is “deserving.” Are recipients viewed as victims of circumstance—or as somehow responsible for their own misfortune? A new Policy & Politics article by Kaila Witkowski and Stephen R. Neely asks how HIV stigma may influence these judgements, with important implications for social policy.
A simple experiment with revealing results
Using a survey of 600 Florida residents, the authors tested whether people living with HIV (PLWH) are perceived as less deserving of unemployment and Medicaid benefits. Participants were shown a brief vignette about a man named Jack who lost his job due to a health issue. Half were told Jack had HIV; the other half were told only that he had an unspecified medical condition.
Although most respondents in both groups believed Jack should receive support, those told he had HIV were significantly less likely to say he was very deserving. They were also less likely to strongly support full unemployment benefits or Medicaid coverage for him.
Why does HIV still carry stigma?
The findings draw on the CARIN model of welfare deservingness, which includes five public judgement criteria:
- Control (is the situation within the person’s control?)
- Attitude (are they trying to improve?)
- Reciprocity (have they contributed to society?)
- Identity (are they relatable?)
- Need (is support genuinely required?)
HIV complicates many of these. It’s still (wrongly) associated with lifestyle choices, reducing perceived control. It also often lacks visible symptoms, which can obscure perceived need. And persistent cultural stigma may reduce public identification with people living with HIV, making them seem more distant or even suspicious to others. Subtle stigma still matters
Importantly, the study suggests that stigma today often operates subtly. Few respondents explicitly said Jack didn’t deserve help. But their support was more lukewarm when HIV was mentioned. This matters. Lower public enthusiasm—even without outright rejection—can still shape the political will to maintain or expand welfare benefits.
In a state like Florida, which has one of the highest rates of new HIV diagnoses in the US and where political resistance to welfare expansion is common, these findings are especially relevant. Public opinion, shaped by stigma, could influence the future of safety nets like Medicaid and unemployment support for people living with HIV.
Policy lessons
This research is a timely reminder that stigma around HIV hasn’t disappeared—it’s just become less visible. Even as medical advances improve the lives of those with chronic conditions, social perceptions still shape access to vital support. Policymakers and advocates should be aware that subtle shifts in public opinion can have real consequences for funding, service design and uptake.
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You can read the original research in Policy & Politics at
Witkowski, K., and Neely, S. R. (2025). Does HIV status affect attitudes on welfare deservingness? A survey experiment on welfare policy in the US. Policy & Politics (published online ahead of print 2025), available from: < https://doi.org/10.1332/03055736Y2024D000000063>
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Blum, S., and Kuhlmann, J. (2025). What defines deservingness? Specifying the criteria for target groups constructions in public policy. Policy & Politics 53, 2, 338-359, available from: < https://doi.org/10.1332/03055736Y2024D000000059>
Goijaerts, J., van der Zwan, N., and Bussemaker, J. (2025). How middle managers perceive and articulate the discrepancy between socio-health service delivery goals and practice. Policy & Politics (published online ahead of print 2025), available from: < https://doi.org/10.1332/03055736Y2025D000000066>
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