HIV-related stressors and psychological functioning among adolescents living with perinatal HIV in KwaZulu-Natal, South Africa
Bibliographic record
Abstract
Introduction Adolescents with perinatally acquired HIV (APHs) in sub-Saharan Africa (SSA) face significant psychological challenges due to HIV-related stressors such as stigma and the burden of chronic illness, which can negatively impact mental health and antiretroviral therapy (ART) adherence. Mental health issues, including depression and anxiety, are common among APHs and often compounded by poverty, orphanhood, and stigma affecting both APHs and their caregivers. This study examines associations between HIV-related stressors (stigma experienced by APHs and their caregivers and the caregiver-perceived burden of the child’s illness) and psychological functioning (depressive symptoms, anxiety, and self-esteem) among APHs in South Africa. Methods This cross-sectional study analyzed baseline data from the VUKA Family Program, an intervention in KwaZulu-Natal, South Africa (2014–2019). The sample included 315 APHs (aged 9–15) and their caregivers. Descriptive statistics assessed psychological functioning and HIV-related stressors. Multivariate regression analyses examined associations between APH-perceived stigma, caregiver-experienced stigma, caregiver-reported burden of the child’s illness, and psychological functioning outcomes. Results Most APHs (M = 11.94 years, SD = 1.55, 52% female) reported high self-esteem (M = 86.3, SD = 10.1) despite experiencing elevated anxiety (M = 4.47, SD = 2.86) and depressive symptoms (M = 7.56, SD = 2.08). Caregivers (M = 40.48 years, SD = 12.96) experienced significant caregiving burden (M = 40.04, SD = 7.73). Both APHs (M = 19.6, SD = 3.80) and caregivers (M = 18.2, SD = 4.61) reported moderate levels of exposure to HIV-related stigma. Regression analyses showed that higher levels of APH-experienced stigma was associated to lower levels self-esteem (b = −0.75, p < 0.001), higher levels of anxiety (b = 0.29, p < 0.001), and depressive symptoms (b = 0.11, p < 0.001). Caregiver stigma predicted higher levels of APH anxiety (b = 0.11, p = 0.01) but was not significantly associated with self-esteem or depressive symptoms. Discussion Findings highlight the critical role of HIV-related stigma in shaping APH mental health. Addressing stigma among APHs and caregivers through targeted interventions may improve psychological outcomes. Future research should explore self-esteem as a protective factor and validate depression scales for APHs in SSA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".