ABSTRACT:
In 2021, Sub-Saharan Africa accounted for 67% of the global HIV burden and 670000 of the world’s 1.5 million new infections. Beyond these figures, people living with HIV experience blame, shame, and social isolation, shaped by the colonial moralisation of sexually transmitted diseases. Over 25 African countries enforce HIV-specific criminalisation laws that extend this moralisation into the legal sphere. This study applies an Africentric Reproductive Justice framework to examine precolonial disease and healing practices in Ghana, Uganda, and Nigeria, and traces how colonial interventions generated stigma through oppressive laws and policies. A critical literature review was conducted. Searches in Google Scholar and ProQuest used two primary strings: (1) "disease" or "illness" and "healing" and "health" or "medicine" and "precolonial" or "Indigenous" or "traditional" and "colonial" and "(Malawi or Nigeria or Uganda or Ghana or Africa)." (2) "HIV" and "stigma" and "criminalisation" and "(Malawi or Uganda or Nigeria or Ghana or Africa)" and "laws" and "policies.” Braun and Clarke’s six-phase thematic analysis framework was applied using an inductive-deductive approach. Traditional understandings of disease in Ghana, Uganda, and Nigeria were holistic and relational, linking physical, spiritual, emotional, and social dimensions and framing illness as a disruption of communal or cosmic harmony rather than individual fault. Traditional healers, spiritual leaders, and community structures fostered collective responsibility, reconciliation, and reintegration, inherently limiting stigma. Colonial and missionary interventions imposed moralised legal frameworks, particularly around sexual and reproductive health, which entrenched stigma that persists in contemporary HIV discourse, framing infection as immorality or personal failing. Sustainable stigma reduction requires: • Amplifying positive African narratives to reshape public perceptions. • Strengthening civil society organisations to deliver culturally grounded education and advocacy. • Supporting African institutions in embedding stigma reduction into legal and governance frameworks. • Empowering individuals to enact everyday practices that normalise dignity, care, and inclusion.