title: "Not Taking it Will Just be Like a Sin": Young People Living with HIV and the Stigmatization of Less-Than-Perfect Adherence to Antiretroviral Therapy.
abstract: Global health priorities are being set to address questions on adherence to HIV antiretroviral therapy in adolescence. Few studies have explored young people's perspectives on the complex host of social and relational challenges they face in dealing with their treatment in secret and their condition in silence. In redressing this, we present findings from a longitudinal qualitative study with young people living with HIV in the UK, Ireland, US, and Uganda, embedded within the BREATHER international clinical trial. Drawing from Goffman's notion of stigma, we analyze relational dynamics in HIV clinics, as rare spaces where HIV is "known," and how young people's relationships may be threatened by non-adherence to treatment. Young people's reflections on and strategies for maintaining their reputation as patients raise questions about particular forms of medicalization of HIV and the moralization of treatment adherence that affect them, and how these may restrict opportunities for care across the epidemic.
authors.affiliation: a School of Public Health , University of Sydney , Sydney , Australia.|b London School of Hygiene and Tropical Medicine , London , United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Bernays
authors.affiliation: b London School of Hygiene and Tropical Medicine , London , United Kingdom.|c Graduate Institute of International and Development Studies , Geneva , Switzerland.
authors.forename: Sara
authors.initials: S
authors.lastname: Paparini
authors.affiliation: d Medical Research Council , Uganda Virus Research Institute , Entebbe , Uganda.
authors.forename: Janet
authors.initials: J
authors.lastname: Seeley
authors.affiliation: b London School of Hygiene and Tropical Medicine , London , United Kingdom.
authors.forename: Tim
authors.initials: T
authors.lastname: Rhodes
mesh_terms: D000328:Adult; D060432:Anthropology, Medical; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000208:ethnology / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000208:ethnology / Q000523:psychology; D057545:Social Stigma; D014454:Uganda; D006113:United Kingdom; D014481:United States; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
keywords: Adolescence; HIV; qualitative; stigma; treatment adherence