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UBC Theses and Dissertations

HIV/STI stigma, gender, and young people Karamouzian, Mohammad


Background: In the context of HIV/STI, there is a large and growing body of literature assessing stigma. However, most studies have concentrated on adult populations, leaving several aspects of HIV/STI-related stigma amongst young people open to question. The current thesis examines the issue of HIV/STI-related stigma on young people’s sexual health. Methods: To examine the potential influence of stigma on STI testing amongst marginalized youth, data from the At-Risk Youth Study (ARYS) was used to examine the influence of stigma on STI testing uptake amongst 300 street-involved young people. To explore young people’s perceptions about the capacity for stigma to be mitigated using online testing approaches, individual, semi-structured interviews were completed with 71 young people and analyzed thematically. Moreover, to characterize the state of the literature regarding HIV-related stigma amongst youth living with HIV (YLHIV), a systematic search of the literature was used to identify 22 studies measuring HIV-related stigma among YLHIV; each study was evaluated to assess how sex or gender considerations were taken into account. Results: Perceived devaluation, was independently associated with decreased STI testing uptake among street-involved youth. Moreover, the qualitative analysis pointed to the potential benefits of online HIV/STI testing for reducing the external stigma, despite the complexities around addressing internalized notions of HIV/STI-related stigma among youth as well as the gendered experiences of HIV/STI-related stigma in online testing environments. Among the 22 papers included in the systematic review, several gaps were identified in the existing literature of HIV-related stigma including the missing accounts of sex or gender on HIV-related stigma among YLHIV. Conclusions: Taken together, the findings of the current thesis suggest that HIV/STI-related stigma affect youth’s sexual health care seeking practices in both online and clinic-based settings – and that experiences may differ by gender. To combat HIV/STI-related stigma and its effects, it will be necessary to address underlying individual- and structural-level factors, including gender stereotypes. However, the current literature does not appear to fully account for youth’s gendered experiences, leaving many interventions to promote youth sexual health insufficiently informed and offering space for new research to address an important theoretical and practice gap.

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