'They should show them love even if their status of being HIV positive is known': Youth and caregiver stigma experience and strategies to end HIV stigma in schools.

Journal: Tropical medicine & international health : TM & IH

Volume: 28

Issue: 6

Year of Publication: 2023

Affiliated Institutions:  Department of Medical Research, Kenyatta National Hospital, Research and Programs, Nairobi, Kenya. Department of Psychiatry, University of Nairobi, Nairobi, Kenya. Department of Global Health, University of Washington, Seattle, Washington, USA.

Abstract summary 

HIV stigma and discrimination is widespread in sub-Saharan Africa and is associated with poor clinical outcomes. Schools play a critical role in the life of youth and have been identified as a potentially stigmatising environment. We sought to explore school HIV stigma drivers, facilitators, manifestations and outcomes among youth living with HIV (YLH) as well as potential stigma reduction interventions in Kenya.Semi-structured in-depth qualitative interviews with 28 school-attending YLH aged 14-19 years and 24 caregivers of YLH were analysed using directed content analysis. Results were summarised using the Health and Stigma Framework.Drivers and facilitators of HIV stigma in the school environment included misconceptions about HIV transmission, HIV treatment outcomes and long-term overall health of people living with HIV. HIV stigma manifested largely as gossip, isolation and loss of friendships. Fear of HIV stigma or experienced stigma resulted in poor adherence to antiretroviral treatment-particularly among YLH in boarding schools-and poor mental health. Stigma also impacted school choice (boarding vs. day school) and prevented HIV disclosure to schools which was necessary for optimal support for care. Proposed interventions to address HIV stigma in schools included HIV education, psychosocial support for YLH, support for HIV disclosure to schools while ensuring confidentiality and building YLH resilience.There is an urgent need to develop interventions to address HIV stigma in schools to ensure optimised health and social outcomes for YLH. Future studies to understand the most effective and efficient interventions are needed.

Authors & Co-authors:  Njuguna Moraa Mugo Mbwayo Nyapara Aballa Wagner Wamalwa John-Stewart Inwani O'Malley

Study Outcome 

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Statistics
Citations :  2025 AIDS TARGETS - UNAIDS [Internet]. [cited 2022 Sep 20]. Available from: https://aidstargets2025.unaids.org/
Authors :  11
Identifiers
Doi : 10.1111/tmi.13878
SSN : 1365-3156
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
adolescents living with HIV;schools;stigma;sub-Saharan Africa;youth living with HIV
Study Design
Study Approach
Qualitative
Country of Study
Kenya
Publication Country
England