Individual-, Interpersonal- and Institutional-Level Factors Associated with HIV Stigma Among Youth in Kenya

Abstract

HIV stigma remains a barrier in achieving optimal HIV treatment. We studied the prevalence and predictors of HIV stigma among adolescents and youth with HIV (AYWHIV) ages 15–24 years in Western Kenya. Of 1011 AYWHIV, 69% were female with a median age of 18 years. Most (59%) attended adolescent clinic days, and 40% attended support groups. One-quarter (27%) had experienced physical, 18% emotional, and 7% sexual violence. The majority of AYWHIV (88%) reported disclosure concerns, 48% reported perceived community stigma, 36% experienced, and 24% internalized stigma. Compared to AYWHIV attending adolescent clinics, those in general/adult clinics had higher internalized stigma. Similarly, having dropped out of school was associated with higher internalized stigma. AYWHIV in sexual relationships had higher experienced stigma and disclosure concerns. Lastly, exposure to violence was associated with higher experienced, internalized, perceived community stigma and disclosure concerns. These risk factors can be targeted when developing stigma-prevention interventions. Supplementary Information The online version contains supplementary material available at 10.1007/s10461-023-03982-9.

Effect of HIV stigma on depressive symptoms, treatment adherence, and viral suppression among youth with HIV

“…A few studies have investigated the reverse relationship, for example demonstrating that poor mental health was associated with higher HIV stigma [25,26]. In this study, we investigated this 'reverse' relationship using baseline data and showed that YWH with depressive symptoms had higher overall stigma scores than those without depressive symptoms [51]. In a longitudinal study from a cohort of adults from multiple SSA countries, good treatment adherence was associated with a steeper decline in mean HIV stigma over time [41].…”

The prevalence of internalized stigma and its association with HIV viral suppression among fully disclosed adolescents and young adults living with HIV (AYLHIV) receiving HIV care in an HIV clinic in Plateau State, Nigeria

“…Furthermore, the study findings showed that participants of secondary educational level and aged 10–19 years had a high proportion of internalized stigma (40/58) and (36/58) respectively. On the contrary, findings from available studies showed dropping out of school increases internal stigma among the AYLHIV [ 22 ]. The study finding could be attributed to the levels of social support from the participants’ schoolmates, teachers, and friends.…”

Self-awareness as the key to successful adherence to antiretroviral therapy among people living with HIV in Indonesia: A grounded theory study

“…Stigma exists in Indonesia, particularly for women living with HIV, and it is the primary cause of non-adherence to ART (Ismail et al, 2022 ; Nurfalah et al, 2019 ; Yona et al, 2021 ). Internal factors, such as lack of motivation and forgetfulness, were also mentioned as barriers to ART adherence (Mugo et al, 2023 ; Sefah et al, 2022 ; Shrestha et al, 2019 ). A mixed-method study by Sefah et al ( 2022 ) found that lower adherence to ART was associated with patients’ belief in herbal medicine and, from qualitative analysis, low motivation arising from pill fatigue, forgetfulness, frequent stock out of drugs, long waiting times, and worrying side-effects became barriers to ART adherence.…”