Stigma reduction Interventions for adolescents and young adults living with HIV in Sub-Saharan African countries: The state of the evidence

Background: HIV-related stigma remains a significant barrier to well-being and access to healthcare for adolescents and young adults living with HIV in Sub-Saharan Africa. Stigma reduction interventions have been developed to address this challenge, but the effectiveness of these interventions in this population is not well-documented. Objectives: This narrative review synthesises the available evidence on the effectiveness of stigma reduction interventions for adolescents and young adults (aged 10-24 years) living with HIV in Sub-Saharan African countries. Methods: A comprehensive literature search was conducted using multiple electronic databases to identify relevant studies evaluating stigma reduction interventions targeting internalised stigma, perceived stigma, HIV disclosure, mental health, antiretroviral therapy (ART) adherence, and viral suppression among the population of interest. Results: Studies were conducted in Uganda, Zimbabwe, Kenya, Malawi, South Africa, Ethiopia, Zambia, and Nigeria. Various types of stigma reduction interventions were identified, including education and awareness campaigns, peer support and mentoring, counselling and psychosocial support, and community-based approaches. The evidence demonstrates the effectiveness of these interventions in reducing internalised, perceived and enacted stigma, improving HIV disclosure, enhancing mental health and well-being, increasing ART adherence, and potentially contributing to viral suppression. Factors influencing intervention effectiveness, such as intervention design, participant characteristics, and the sociocultural context, are discussed. Conclusion: Stigma reduction interventions have shown promise in improving a range of outcomes for adolescents and young adults living with HIV in Sub-Saharan Africa. However, more research is needed to identify the most effective intervention strategies and to explore the long-term impact on health outcomes.