Background: HIV-related stigma diminishes the quality of life of affected patients. Little is known about perceived\nand enacted stigma of HIV-infected children in resources-limited settings. We documented the prevalence of\nperceived stigma and associated factors associated among children on antiretroviral therapy (ART) at a referral\nhospital in Cambodia.\nMethods: After informed consent, a standardized pre-tested 47-item questionnaire was confidentially administered\nto consecutive children (7 to 15 years) or their guardians if the child was 18 months to 6 years, during their routine\nART visits. The questionnaire explored the sociodemographics of the child and the parents, HIV history, adherence\nto ART, tolerance of ART and perceived stigma. Associations between perceived stigma and the children s characteristics\nwere measured by bivariate and multivariate analyses.\nResults: Of 183 children, 101 (55.2%) had lost at least one and 45 (24.6%) both parents; 166 (90.7%) went to school. Of\n183 children (female: 84, 45.9%, median age 7.0 years, interquartile range: 2.0-9.6), 79 (43.2%) experienced perceived\nstigma, including rejection by others (26.8%), no invitations to social activities (18.6%) and exclusion from games (14.2%).\nA total of 43 (23.5%) children were fearful of their disease and 61 (53.9%) of 113 older than 6 years reported knowledge\nof their HIV status. Of 136 children over five years and eligible for education, 7 (3.8%) could not go to school due to\nperceived stigma. Incomplete adherence to ART was reported for 17 (9.2%) children. In multivariate analysis, school\nattendance (odds ratio [OR]: 3.9; 95% confidence interval [CI]: 2.0-7.9) and income of less than one dollar per person\nper day (OR: 2.2, 95% CI: 1.1-4.5) were associated with perceived stigma. Conversely, receipt of social support (OR: 0.4,\n95% CI 0.2-0.9) was associated with lower risk of perceived stigma.\nConclusion: Perceived stigma in pediatric ART patients remains a significant issue in Cambodia. Psychological support\nand interventions should be developed in hospitals, schools, and underprivileged communities to prevent HIV-related\nstigma for affected children.
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