Correlation between Stigma and Adherence to ART among HIV-Positive Adolescents: A Cross-Sectional Study

Shaily B Surti; JK Kosambiya; Patni MohamedAnas MohamedFaruk

Shaily B Surti Assistant Professor, Dept. of Community Medicine, Parul Institute of Medical Science and Research, Parul University Gujarat, India.
JK Kosambiya Professor & Head, Dept. of Community Medicine, Government Medical College, Surat, Gujarat, India.
Patni MohamedAnas MohamedFaruk Assistant Professor, Dept. of Community Medicine, Government Medical College, Surat, Gujarat, India.

Keywords: HIV-Positive Adolescents, Stigma, Knowledge, HIV Transmission, Adherence to ART

Abstract

Despite the prominence of youth on the global agenda, young people are often left behind in national HIV responses. UNAIDS estimates indicate that AIDS-related deaths among young people are increasing. One of the reasons for this is poor prioritization of adolescents in national plans for scale-up of HIV testing, treatment and counseling services. The objectives of the current study was to: (1) To understand the social issues such as stigma and disclosure faced by them (2) To document the adherence to ART among them and study the effect of stigma on it. The cross-sectional study was conducted at HIV clinic, at ART Centre, Surat (Tertiary Care Level Institute) among adolescents between age-group 13-19 years during December-2015 to February-2016. By purposive sampling following desk review of Hospital data, 105 participants were enrolled. Frequency distribution, Factor analysis and Correlation were utilized for analysis. Around 80% feared that they will lose their friends if they came to know about their serostatus. Factor analysis yielded 2 factors- Blaming and Distancing. These two factor scores were found significantly correlated to adherence to ART. Only 7% chose to share about the status with friends outside the family. The study findings suggest that there is a need for prioritizing adolescent health among seropositives as their difficulties are different than children and adults in handling social issues like stigma due to their age and peer pressure. The lack of knowledge and fear of stigma among them if not addressed may lead to poor adherence to treatment and therefore, clinical complications.

How to cite this article:
Surti SB, Kosambiya JK, MohamedFaruk PMA. Correlation between Stigma and Adherence to ART among HIV-Positive Adolescents: A Cross-Sectional Study. Ind J Youth Adol Health2021;8(1):1-7.

DOI: https://doi.org/10.24321/2349.2880.202101

References

UNAIDS. Global estimates. 2019. Available from: https://www.unaids.org/sites/default/files/media_

asset/2019-UNAIDS-data_en.pdf

UNICEF, UNICEF. Data: Monitoring the situation of children and women.2019. Available from: https://

data.unicef.org/resources/sowc-2019-statistical-tablesand-interactive-dashboard/

UNAIDS . Country report: India.2019. Available from: https://www.unaids.org/en/regionscountries/

countries/india

Bikaako-Kajura W, Luyirika E, Purcell DW, Downing J, Kaharuza F, Mermin J, Malamba S, Bunnell R.

Disclosure of HIV status and adherence to daily drug regimens among HIV-infected children in Uganda. AIDS

Behav.2006;10(4 Suppl):S85-93. [PubMed] [Google Scholar].

Haberer JE, Cook A, Walker AS, Ngambi M, Ferrier A, Mulenga V, Kityo C, Thomason M, Kadamba D, Chintu

C, Gibb DM, Bangsberg DR. Excellent adherence to antiretrovirals in HIV+ Zambian children is compromised

by disrupted routine, HIV nondisclosure, and paradoxical income effects. PLoS One.2011;6(4):e18505. [PubMed]

[Google Scholar].

Major B,Oâ€™Brien LT. The social psychology of stigma. Annu Rev Psychol.2005;56:393-421. [PubMed] [Google

Scholar].

Weiser S, Wolfe W, Bangsberg D, Thior I, Gilbert P, Makhema J, Kebaabetswe P, Dickenson D, Mompati

K, Essex M, Marlink R. Barriers to antiretroviral adherence for patients living with HIV infection

and AIDS in Botswana. J Acquir Immune Defic Syndr.2003;34(3):281-8. [PubMed] [Google Scholar]

Nichols S. Neuropsychology of HIV in children and adolescents. Psychology and AIDS Exchange

Newsletter.2014.

Modi M, Sharma N, Sharma A, Marfatia YS. HIV infection in adolescents: A rising concern. Indian Journal of

Sexually Transmitted Diseases and AIDS.2008;29(2):73-75. [Google Scholar].

National behavioural Surveillance Survey 2006, National AIDS Control Organisation, India. Available from: http://naco.gov.in/sites/default/files/Youth_report_1.pdf

Sekoni AO, Obidike OR, Balogun MR. Stigma, medication adherence and coping mechanism among people living with HIV attending General Hospital, Lagos Island, Nigeria. Afr J Prm Health Care Fam Med. 2012;4(1):417.

[Google Scholar].

Bharat S. A systematic review of HIV/AIDS-related stigma and discrimination in India: Current understanding and future needs. SAHARA J. 2011;8(3):138-49. [PubMed] [Google Scholar].

Malcolm A, Aggleton P, Bronfman M, Galvao J, Mane P, Verrall J. HIV-related stigmatization and

discrimination: Its forms and contexts. Critical Public Health.1998;8(4):347-370. [Google Scholar].

Tanney MR, Naar-King S, MacDonnel K. Depression and Stigma in High Risk Youth Living with HIV: A Multisite

Study. Journal of Pediatric Health Care.2012;26(4):300-305. [Google Scholar].

Bhattacharya M, Dubey AP, Sharma M. Patterns of Diagnosis Disclosure and its Correlates in HIV-Infected

North Indian Children. J Trop Pediatr. 2011;57(6):405-411. [PubMed] [Google Scholar].

Arrive E, Dicko F, Amghar H, Aka AE, Dior H, Bouah B, Traore M, Ogbo P, Dago-Akribi HA, Eboua TKF,

Kouakou K, Sy HS, Alioum A, Dabis F, Ekouevi DK, Leroy V, Pediatric IeDEA West Africa Working Group. HIV

Status Disclosure and Retention in Care in HIV-Infected Adolescents on Antiretroviral Therapy (ART) in West

Africa. PLoS One.2012;7(3):e33690. [PubMed] [Google Scholar].

Nostlinger C, Bakeera-Kitaka S, Buyze J, Loos J, Buve A. Factors influencing social self-disclosure among

adolescents living with HIV in Eastern Africa. AIDS Care.2015;27 Suppl 1:36-46. [PubMed] [Google

Scholar].18. Gaur AH, Belzer M, Britto P, Garvie PA, Hu C, Graham B, Neely M, McSherry G, Spector SA, Flynn PM,

Pediatric AIDS Clinical Trials Group. Directly observed therapy (DOT) for nonadherent HIV-infected youth:

lessons learned, challenges ahead. AIDS Res Hum Retroviruses.2010;26(9):947-53. [PubMed] [Google

Scholar].

Nyogea D, Mtenga S, Henning L, Franzeck FC, Glass TR, Letang E, Tanner M, Geubbels E. Determinants of

antiretroviral adherence among HIV positive children and teenagers in rural Tanzania: a mixed methods

study. BMC Infectious Diseases.2015;15(1):28. [Google Scholar].