The Pros and Cons of Perceived HIV-Related Stigma in Younger and Older Adolescents in Botswana

Open Access
- Author:
- Grullon-Perez, Karina
- Area of Honors:
- Science
- Degree:
- Bachelor of Science
- Document Type:
- Thesis
- Thesis Supervisors:
- Dr. Joshua George Rosenberger, Thesis Supervisor
Dr. Ronald Albert Markle, Thesis Honors Advisor
Kari Christine Kugler, Faculty Reader - Keywords:
- HIV
HIV-related stigma
Stigma
Adolescents
Treatment outcomes
Anticipated stigma
Experienced stigma
Internalized stigma - Abstract:
- The HIV Stigma Framework suggests that HIV-related stigma impacts individuals living with HIV via a series of stigma mechanisms, which includes experienced stigma (i.e., be subject to discrimination), anticipated stigma (i.e., change thoughts or behaviors to avoid discrimination), and internalized stigma (i.e., think less of themselves because of their HIV serostatus). HIV-related stigma in adults living with HIV has been associated with increased risk-taking behavior, reduced uptake of HIV testing, and decreased adherence to antiretroviral therapy (ART). Children with perinatally acquired HIV, whose caregivers have experienced or anticipated stigma, have excellent adherence in an effort to prevent the unnecessary disclosure of the child’s status; however, the effect of HIV-related stigma on adolescents with perinatally acquired HIV remains unknowns. Using data from 289 adolescents living with HIV (ALWH) in Botswana, we tested the hypotheses that adolescents’ self-reports of perceived stigma are associated with virologic failure (VF) and the association between perceived stigma and VF differs in younger and older adolescents. Results suggest that age is an effect modifier of the relationship between perceived stigma and VF. For older adolescents (>17 years of age), there was an increased risk of VF with increasing stigma, but for younger adolescents (≤17 years of age) there was a decreased risk of VF with increasing stigma (interaction p<0.001). Further research is needed to understand the reason why younger adolescents are protected from stigma, but the results from this study reinforce that the transition to young adulthood increases the risk for stigma to influence HIV-related health outcomes.