Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
AIDS Behav. 2023 May;27(Suppl 1):162-184. doi: 10.1007/s10461-022-03793-4. Epub 2022 Jul 30.
Adolescents in sub-Saharan Africa, specifically adolescent girls and young women, young men who have sex with men, transgender persons, persons who use substances, and adolescents experiencing homelessness experience intersectional stigma, have a high incidence of HIV and are less likely to be engaged in HIV prevention and care. We conducted a thematic analysis informed by the Health and Discrimination Framework using a multiple case study design with five case studies in 3 sub-Saharan African countries. Our analysis found commonalities in adolescents' intersectional stigma experiences across cases, despite different contexts. We characterize how intersectional stigma impacts the uptake and implementation of HIV prevention and treatment services along the continuum for adolescents. Findings reveal how intersectional stigma operates across social-ecological levels and worsens HIV-related outcomes for adolescents. We identify opportunities for implementation science research to address stigma-related barriers to the uptake and delivery of HIV services for adolescents in sub-Saharan Africa.
撒哈拉以南非洲的青少年，特别是少女和年轻妇女、与男性发生性关系的年轻男性、跨性别者、使用物质的人和无家可归的青少年，都经历着交叉歧视，艾滋病毒感染率较高，参与艾滋病毒预防和护理的可能性较低。我们采用健康和歧视框架进行了主题分析，并采用多案例研究设计，在撒哈拉以南非洲的 3 个国家进行了 5 个案例研究。我们的分析发现，尽管背景不同，但在各个案例中，青少年交叉歧视的经历具有共性。我们描述了交叉歧视如何影响青少年在整个预防和治疗服务连续体中的接受和实施。研究结果揭示了交叉歧视是如何在社会-生态层面运作的，以及它如何恶化青少年的艾滋病毒相关后果。我们确定了实施科学研究的机会，以解决撒哈拉以南非洲青少年在接受和提供艾滋病毒服务方面与耻辱感相关的障碍。
