Background <p>AIDS/HIV is a major public health challenge that, in addition to physical complications, is accompanied by social stigma and negative impacts on mental health and quality of life. Identifying the needs of people living with HIV (PLHIV) and aligning them with NANDA nursing diagnoses can strengthen person-centered and evidence-based care. This study aimed to extract needs based on perceived stigma and map them to NANDA nursing diagnosis patterns.</p> Materials and methods <p>This study employed a directed qualitative content analysis approach, based on the framework proposed by Hsieh and Shannon (2005). It was conducted in 2024 with 21 people living with HIV (PLHIV) recruited from health centers in East Tehran, Iran. Data were collected through semi-structured interviews using purposive sampling, and analysis was guided by six predefined NANDA nursing diagnosis domains.</p> Results <p>Most participants were male, with a mean age of 38.52 ± 9.75 years. Directed content analysis resulted in the identification of 11 main categories and 42 subcategories. Findings indicated that perceived stigma influences the multidimensional needs of PLHIV, including physical, psychological, social, sexual, coping-related, and spiritual needs within NANDA diagnosis patterns.</p> Conclusion <p>Perceived stigma broadly affects the physical, psychological, social, sexual, and spiritual care needs of PLHIV. The use of NANDA nursing diagnosis patterns enables a systematic explanation of these needs and guides the development of comprehensive, individualized, culturally-congruent, and evidence-informed nursing care, which may improve treatment adherence and enhance quality of life.</p> Clinical trial number <p>Not applicable.</p>