Co-occurring stigmas and associations with HIV testing, mental health, and substance use: a latent class analysis among youth in Kazakhstan.

BACKGROUND

Co-occurring perceived community stigmas (HIV, sexual/gender minority status and substance use) impact health behaviors and access to healthcare services, particularly in low- and middle-income countries, but there is a paucity of research among adolescents and young adults). This paper explores the associations between co-occurring perceived community stigmas (HIV, sexual/gender minority status and substance use) and their relationship to mental health and substance use outcomes among youth in Kazakhstan.

METHODS

Participants were 216 (females: 116, males: 110) youth living in Almaty, Kazakhstan, who were not diagnosed with HIV. We used multidimensional latent class analyses to identify groups of youth with different combinations of perceived community stigmas.

RESULTS

The four latent classes are: (1) low levels of all stigma types (26%, n = 56); (2) low levels of HIV stigma with moderate levels of substance use and sexual/gender minority status stigmas (44%, n = 95); (3) moderate levels of HIV and sexual/gender minority status stigmas with low substance use stigma (9%, n = 19); and (4) high levels of all stigma types (21%, n = 46). Adolescents and young adults in Class 4 had higher odds of self-identifying as a sexual/gender minority (OR 2.70; 95% CI: 1.09, 6.69) compared with Class 1. Youth in Class 4 had higher depression (M 13.88, s.d. 7.52) and anxiety (M 9.00, s.d. 6.82) compared with Class 1 (M 9.00, s.d. 6.01; M 5.2, s.d. 5.38, respectively). Youth in Class 2 were 2.47 times (95% CI: 1.23, 4.93) more likely to have used tobacco, and 2.06 times (95% CI: 1.05, 4.06) more likely to have used alcohol than Class 1.

CONCLUSION

Discrete typologies of perceived co-occurring community stigmas are differentially associated with health outcomes, suggesting a need for interventions to address co-occurring stigmas.