Journal article
Bullying and ART non-adherence among South African adolescents living with HIV: effects, risk and protective factors
- Abstract:
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Background: Identifying risk and protective factors for adolescent antiretroviral therapy (ART) adherence is a public health priority, given high HIV-related mortality in this population. An area that merits further investigation is the relationship between bullying victimization, mental health problems, and ART non-adherence among adolescents living with HIV (ALHIV). However, no known studies assess effects of bullying on adolescent non-adherence, or risk and protective factors that could moderate this relationship.
Setting: This study investigates a) the direct longitudinal relationship between bullying exposure and ART non-adherence, and the indirect relationship via psychological distress, and b) potential risk and modifiable protective factors moderating these pathways, among vertically and horizontally infected ALHIV who initiated treatment across 53 public healthcare facilities in a South African health district.
Methods: Survey data was collected at two-time points, between 2014 and 2017, with 1046 ALHIV (94% retention). Various mediation and moderated mediation models were run as part of a staged analysis approach.
Results: A significant longitudinal relationship was found between bullying victimization and non-adherence, operating indirectly via psychological distress (B= 0.07; 95%CI: [0.03, 0.13]). Moderation analyses indicated that older adolescents exposed to bullying are more at risk of non-adherence (B =0.52; 95%CI: [0.07, 0.97] p<0.05), and parental monitoring is a potential protective factor buffering indirect effects of bullying on non-adherence (B =-0.22; 95%CI: [-0.42, -0.02] p<0.05).
Conclusions: These findings underscore the importance of interventions that address bullying and psychological distress, and strengthen parental monitoring, particularly among older ALHIV.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Accepted manuscript, pdf, 211.2KB, Terms of use)
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- Publisher copy:
- 10.1097/QAI.0000000000002574
Authors
- Publisher:
- Lippincott, Williams and Wilkins
- Journal:
- Journal of Acquired Immune Deficiency Syndromes More from this journal
- Volume:
- 86
- Issue:
- 4
- Pages:
- 436-444
- Publication date:
- 2020-11-17
- Acceptance date:
- 2020-10-20
- DOI:
- EISSN:
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1944-7884
- ISSN:
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1525-4135
- Language:
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English
- Keywords:
- Pubs id:
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1140201
- Local pid:
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pubs:1140201
- Deposit date:
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2020-10-31
- ARK identifier:
Terms of use
- Copyright holder:
- Wolters Kluwer Health
- Copyright date:
- 2020
- Rights statement:
- © 2020 Wolters Kluwer Health, Inc. All rights reserved.
- Notes:
- This is the accepted manuscript version of the article. The final version is available online from Lippincott, Williams and Wilkins at: http://dx.doi.org/10.1097/QAI.0000000000002574
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