Perger Teodora, Davtyan Mariam, Foster Caroline, Evangeli Michael, Berman Claire, Kacanek Deborah, Puga Ana M, Sekidde Serufusa, Bhopal Sanj
ViiV Healthcare, Brentford, UK.
University of Southern California, Los Angeles, CA, USA.
AIDS Behav. 2025 Feb;29(2):497-516. doi: 10.1007/s10461-024-04534-5. Epub 2024 Oct 25.
HIV-related stigma is associated with negative effects on mental health and lower health-related quality of life in pediatric and young adult populations living with HIV. We reviewed literature on the impact of HIV-related stigma on suboptimal antiretroviral therapy (ART) adherence, engagement and retention in HIV care, and transition to adult HIV care in children, adolescents, and young adults living with HIV. PubMed and Embase were searched for publications reporting relevant data published from January 1, 2012, to April 13, 2023. The output was not a systematic review; it was a targeted literature review. Overall, 67 studies were selected for analysis based on pre-specified criteria (eg, quality). Most quantitative studies supported negative associations between HIV-related stigma and ART adherence (n = 8/11), engagement and retention in HIV care (n = 3/4), and transition to adult HIV care (n = 2/3) in pediatric and young adult populations living with HIV. Qualitative studies reported that stigma was a barrier to ART adherence (n = 26), engagement and retention in HIV care (n = 18), and transitioning to adult HIV care (n = 11). Prominent interview themes across all topics included anticipated stigma, enacted stigma, and fear of HIV status disclosure. Results reaffirm that HIV-related stigma is a significant barrier to ART adherence, engagement and retention in HIV care, and transition to adult HIV care among pediatric and young adult populations living with HIV, potentially impacting virologic suppression, onward transmission, and longer-term health. Additional interventional studies are needed to evaluate and reduce the impact of stigma in these important populations.
与艾滋病毒相关的耻辱感会对感染艾滋病毒的儿童和青年人群的心理健康产生负面影响，并降低其与健康相关的生活质量。我们回顾了关于与艾滋病毒相关的耻辱感对接受抗逆转录病毒治疗（ART）的依从性不佳、参与和持续接受艾滋病毒护理以及感染艾滋病毒的儿童、青少年和青年向成人艾滋病毒护理过渡的影响的文献。在PubMed和Embase上搜索了2012年1月1日至2023年4月13日期间发表的报告相关数据的出版物。本产出不是系统评价，而是有针对性的文献综述。总体而言，根据预先设定的标准（如质量），选择了67项研究进行分析。大多数定量研究支持在感染艾滋病毒的儿童和青年人群中，与艾滋病毒相关的耻辱感与ART依从性（n = 8/11）、参与和持续接受艾滋病毒护理（n = 3/4）以及向成人艾滋病毒护理过渡（n = 2/3）之间存在负相关。定性研究报告称，耻辱感是ART依从性（n = 26）、参与和持续接受艾滋病毒护理（n = 18）以及向成人艾滋病毒护理过渡（n = 11）的障碍。所有主题中突出的访谈主题包括预期的耻辱感、实际遭受的耻辱感以及对艾滋病毒感染状况披露的恐惧。结果再次证实，与艾滋病毒相关的耻辱感是感染艾滋病毒的儿童和青年人群坚持ART治疗、参与并持续接受艾滋病毒护理以及向成人艾滋病毒护理过渡的重大障碍，可能影响病毒抑制、病毒传播和长期健康。需要更多的干预性研究来评估和减少耻辱感对这些重要人群的影响。
