Abstract：
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.
摘要：
撒哈拉以南非洲有140多万青少年感染艾滋病毒，他们中的大多数人通过围产期传播（PHIVE）获得病毒。艾滋病毒的污名在感染艾滋病毒的青少年中尤其严重，并且与一些结果有关，这些结果使健康状况恶化并增加了艾滋病毒继续传播的风险。我们在一年的时间里，在索韦托的一名男性青少年样本中，测试了内化的艾滋病毒污名和其中四个结果之间的关联，南非。参与者（N=241）在基线时回答了有关内在化HIV污名的问题。他们在接下来的一年中完成了每周的移动调查，以回答有关抑郁症经历的问题，暴饮暴食,药物依从性,暴力受害。使用广义线性混合模型，我们发现，基线内化的HIV污名与抑郁几率增加相关（OR1.74），酒精滥用（OR2.09），以及暴力受害（OR1.44）和一年内药物依从性的几率降低（OR0.60）。这些结果对感染艾滋病毒的青少年的健康和福祉产生负面影响，并增加他们将来将艾滋病毒传播给伴侣的风险。我们的发现提供了新颖的，艾滋病毒污名有害影响的纵向证据。为了改善患有艾滋病毒的青少年的健康结果，至关重要的是制定有效的减少艾滋病毒污名的干预措施，以解决特定的发展问题，性别,和文化体验。
