The Burden of HIV Stigma and Associated Factors among HIV Infected Adolescents Attending HIV Clinics in Kampala City: A Cross-Sectional Study in Uganda.

Abstract

Background and aim: The Current HIV/AIDS pandemic is accompanied by undeniable stigma against people living with HIV/AIDS (PLWHA). Most studies on HIV-related stigma have been among adults, and they report that it is a major hindrance to various HIV treatment goals among PLWHA. However, there is scanty literature on HIV-related stigma among adolescents. This study aimed to determine the burden of HIV stigma and associated factors among HIV-infected adolescents in Uganda.

Methods: We conducted a descriptive cross-sectional study among 370 HIV-infected adolescents aged 10-17 years attending HIV clinics in Kampala Capital City Authority (KCCA) health facilities. HIV stigma was assessed using the 11-item Stigma in AIDS Family Inventory (SAFI) tool, depression and suicidal ideation were assessed using the Child Depression Inventory (CDI) tool, while HA ART adherence and social support determined using the missed-dose method and the 12-item Multidimensional Scale of Perceived Social Support (MSPSS) tools respectively. Data was analysed using STATA 16. Logistic regression analyses were used to assess the factors associated with HIV stigma. A P < 0.05 was considered statistically significant.

Results: Overall, 370 adolescents, with a mean age of 15.5 years (Standard deviation, SD = 2.88) and a female preponderance (216, 58.4%) participated in this study. The prevalence of high-level HIV stigma was 33.5% (Mean score = 9.53, SD = 6.33). Orphan status (AOR = 1.65, 95% CI = 1.15 - 2.37, P = 0.007), Depression (AOR = 1.10, 95%CI = 1.06 - 1.15, P < 0.0001), being with suicidal ideation (AOR = 2.48, 95%CI = 1.06-5.81, P = 0.036), perceived low social support (AOR = 0.94, 95%CI = 0.91 - 0.97, P = < 0.0001), Poor HAART adherence (AOR = 2.12, 95%CI = 1.23 = 3.63, P = 0.007), and undisclosed HIV status (AOR = 0.06, 95%CI = 0.01 - 0.42, P = 0.004) were independently associated with high HIV stigma.

Conclusion: The prevalence of HIV stigma among adolescents living with HIV/AIDS is substantial. HIV-infected adolescents should be provided with psychosocial counseling, social support, and routine close mental health monitoring to combat psychological stigma which can lead to full-blown psychiatric disorders. This may be better achieved by integrating mental health services into HIV care.