Program in Public Health, State University of New York at Stony Brook, Stony Brook, NY, 11794, USA.
Department of Social Work, Faculty of Humanities, University of the Witwatersrand, Johannesburg, 2000, South Africa.
AIDS Behav. 2024 Oct;28(10):3197-3204. doi: 10.1007/s10461-024-04407-x. Epub 2024 Jun 10.
There are over 1.4 million adolescents living with HIV in sub-Saharan Africa, the majority of whom acquired the virus through perinatal transmission (PHIV). HIV stigma is particularly high among adolescents living with HIV and is associated with several outcomes that worsen health and increase the risk of onward HIV transmission. We tested associations between internalized HIV stigma and four of these outcomes over a one-year period among a sample of adolescent boys living with PHIV in Soweto, South Africa. Participants (N = 241) answered questions about internalized HIV stigma at baseline. They completed weekly mobile surveys over the following year to answer questions about their experiences with depression, binge drinking, medication adherence, and violence victimization. Using generalized linear mixed models, we found that baseline internalized HIV stigma was associated with increased odds of depression (OR 1.74), alcohol misuse (OR 2.09), and violence victimization (OR 1.44) and decreased odds of medication adherence (OR 0.60) over the course of a year. These outcomes negatively impact the health and wellbeing of adolescents living with PHIV and increase their risk of transmitting HIV to their partners in the future. Our findings provide novel, longitudinal evidence for the deleterious effects of HIV stigma. To improve health outcomes for adolescents with PHIV, it will be crucial to develop effective HIV stigma reduction interventions that address specific developmental, gendered, and cultural experiences.
在撒哈拉以南非洲，有超过 140 万青少年携带艾滋病毒，其中大多数是通过母婴传播（PHIV）感染的。艾滋病毒污名在携带艾滋病毒的青少年中尤其严重，与一些恶化健康状况和增加艾滋病毒传播风险的结果有关。我们在南非索韦托的 PHIV 青少年男孩样本中，在一年的时间内，测试了内化的艾滋病毒污名与其中四个结果之间的关联。参与者（N=241）在基线时回答了关于内化的艾滋病毒污名的问题。他们在接下来的一年中每周通过移动调查回答有关抑郁、狂饮、药物依从性和暴力受害经历的问题。使用广义线性混合模型，我们发现基线内化的艾滋病毒污名与抑郁（OR 1.74）、酒精滥用（OR 2.09）和暴力受害（OR 1.44）的几率增加以及药物依从性（OR 0.60）的几率降低有关在一年的时间里。这些结果对 PHIV 青少年的健康和福祉产生负面影响，并增加了他们未来将艾滋病毒传染给伴侣的风险。我们的研究结果为艾滋病毒污名的有害影响提供了新颖的纵向证据。为了改善 PHIV 青少年的健康结果，开发针对特定发展、性别和文化经验的有效艾滋病毒污名减少干预措施将至关重要。
