Bullying and ART Nonadherence Among South African ALHIV: Effects, Risks, and Protective Factors
Background:Identifying risk and protective factors for adolescent antiretroviral therapy (ART) adherence is a public health priority, given high HIV-related mortality in this population. An area that merits further investigation is the relationship between bullying victimization, mental health probl...
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| Format: | Journal Article |
| Language: | English |
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LIPPINCOTT WILLIAMS & WILKINS
2021
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1173043 http://hdl.handle.net/20.500.11937/93184 |
| _version_ | 1848765705685565440 |
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| author | Casale, M. Cluver, L. Boyes, Mark Toska, E. Gulaid, L. Armstrong, A. Shenderovich, Y. Rudgard, W.E. Zhou, S. Langwenya, N. |
| author_facet | Casale, M. Cluver, L. Boyes, Mark Toska, E. Gulaid, L. Armstrong, A. Shenderovich, Y. Rudgard, W.E. Zhou, S. Langwenya, N. |
| author_sort | Casale, M. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background:Identifying risk and protective factors for adolescent antiretroviral therapy (ART) adherence is a public health priority, given high HIV-related mortality in this population. An area that merits further investigation is the relationship between bullying victimization, mental health problems, and ART nonadherence among adolescents living with HIV (ALHIV). However, no known studies assess effects of bullying on adolescent nonadherence or risk and protective factors that could moderate this relationship.Setting:This study investigates (1) the direct longitudinal relationship between bullying exposure and ART nonadherence, and the indirect relationship via psychological distress, and (2) potential risk and modifiable protective factors moderating these pathways, among vertically and horizontally infected ALHIV who initiated treatment across 53 public health care facilities in a South African health district.Methods:Survey data were collected at 2 time points, between 2014 and 2017, with 1046 ALHIV (94% retention). Various mediation and moderated mediation models were run as part of a staged analysis approach.Results:A significant longitudinal relationship was found between bullying victimization and nonadherence, operating indirectly through psychological distress [B = 0.07; 95% confidence interval (CI): (0.03 to 0.13)]. Moderation analyses indicated that older adolescents exposed to bullying are more at risk of nonadherence [B = 0.52; 95% CI: (0.07 to 0.97) P < 0.05], and parental monitoring is a potential protective factor buffering indirect effects of bullying on nonadherence [B = -0.22; 95% CI: (-0.42 to -0.02) P < 0.05].Conclusions:These findings underscore the importance of interventions that address bullying and psychological distress, and strengthen parental monitoring, particularly among older ALHIV. |
| first_indexed | 2025-11-14T11:39:30Z |
| format | Journal Article |
| id | curtin-20.500.11937-93184 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:39:30Z |
| publishDate | 2021 |
| publisher | LIPPINCOTT WILLIAMS & WILKINS |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-931842023-10-03T04:52:09Z Bullying and ART Nonadherence Among South African ALHIV: Effects, Risks, and Protective Factors Casale, M. Cluver, L. Boyes, Mark Toska, E. Gulaid, L. Armstrong, A. Shenderovich, Y. Rudgard, W.E. Zhou, S. Langwenya, N. Science & Technology Life Sciences & Biomedicine Immunology Infectious Diseases bullying victimization ART nonadherence adolescents mental health parental monitoring MENTAL-HEALTH DIFFICULTIES MIDDLE-INCOME COUNTRIES ADOLESCENT DEPRESSION ANTISOCIAL-BEHAVIOR HIV CHILDREN SCHOOL VICTIMIZATION ADHERENCE INTERVENTIONS Adolescent Anti-HIV Agents Bullying Child Family Female HIV Infections HIV-1 Humans Male Medication Adherence Psychological Distress Risk Factors Schools Young Adult Humans HIV-1 HIV Infections Anti-HIV Agents Risk Factors Family Schools Adolescent Child Female Male Medication Adherence Young Adult Bullying Psychological Distress Background:Identifying risk and protective factors for adolescent antiretroviral therapy (ART) adherence is a public health priority, given high HIV-related mortality in this population. An area that merits further investigation is the relationship between bullying victimization, mental health problems, and ART nonadherence among adolescents living with HIV (ALHIV). However, no known studies assess effects of bullying on adolescent nonadherence or risk and protective factors that could moderate this relationship.Setting:This study investigates (1) the direct longitudinal relationship between bullying exposure and ART nonadherence, and the indirect relationship via psychological distress, and (2) potential risk and modifiable protective factors moderating these pathways, among vertically and horizontally infected ALHIV who initiated treatment across 53 public health care facilities in a South African health district.Methods:Survey data were collected at 2 time points, between 2014 and 2017, with 1046 ALHIV (94% retention). Various mediation and moderated mediation models were run as part of a staged analysis approach.Results:A significant longitudinal relationship was found between bullying victimization and nonadherence, operating indirectly through psychological distress [B = 0.07; 95% confidence interval (CI): (0.03 to 0.13)]. Moderation analyses indicated that older adolescents exposed to bullying are more at risk of nonadherence [B = 0.52; 95% CI: (0.07 to 0.97) P < 0.05], and parental monitoring is a potential protective factor buffering indirect effects of bullying on nonadherence [B = -0.22; 95% CI: (-0.42 to -0.02) P < 0.05].Conclusions:These findings underscore the importance of interventions that address bullying and psychological distress, and strengthen parental monitoring, particularly among older ALHIV. 2021 Journal Article http://hdl.handle.net/20.500.11937/93184 10.1097/QAI.0000000000002574 English http://purl.org/au-research/grants/nhmrc/1173043 LIPPINCOTT WILLIAMS & WILKINS unknown |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Immunology Infectious Diseases bullying victimization ART nonadherence adolescents mental health parental monitoring MENTAL-HEALTH DIFFICULTIES MIDDLE-INCOME COUNTRIES ADOLESCENT DEPRESSION ANTISOCIAL-BEHAVIOR HIV CHILDREN SCHOOL VICTIMIZATION ADHERENCE INTERVENTIONS Adolescent Anti-HIV Agents Bullying Child Family Female HIV Infections HIV-1 Humans Male Medication Adherence Psychological Distress Risk Factors Schools Young Adult Humans HIV-1 HIV Infections Anti-HIV Agents Risk Factors Family Schools Adolescent Child Female Male Medication Adherence Young Adult Bullying Psychological Distress Casale, M. Cluver, L. Boyes, Mark Toska, E. Gulaid, L. Armstrong, A. Shenderovich, Y. Rudgard, W.E. Zhou, S. Langwenya, N. Bullying and ART Nonadherence Among South African ALHIV: Effects, Risks, and Protective Factors |
| title | Bullying and ART Nonadherence Among South African ALHIV: Effects, Risks, and Protective Factors |
| title_full | Bullying and ART Nonadherence Among South African ALHIV: Effects, Risks, and Protective Factors |
| title_fullStr | Bullying and ART Nonadherence Among South African ALHIV: Effects, Risks, and Protective Factors |
| title_full_unstemmed | Bullying and ART Nonadherence Among South African ALHIV: Effects, Risks, and Protective Factors |
| title_short | Bullying and ART Nonadherence Among South African ALHIV: Effects, Risks, and Protective Factors |
| title_sort | bullying and art nonadherence among south african alhiv: effects, risks, and protective factors |
| topic | Science & Technology Life Sciences & Biomedicine Immunology Infectious Diseases bullying victimization ART nonadherence adolescents mental health parental monitoring MENTAL-HEALTH DIFFICULTIES MIDDLE-INCOME COUNTRIES ADOLESCENT DEPRESSION ANTISOCIAL-BEHAVIOR HIV CHILDREN SCHOOL VICTIMIZATION ADHERENCE INTERVENTIONS Adolescent Anti-HIV Agents Bullying Child Family Female HIV Infections HIV-1 Humans Male Medication Adherence Psychological Distress Risk Factors Schools Young Adult Humans HIV-1 HIV Infections Anti-HIV Agents Risk Factors Family Schools Adolescent Child Female Male Medication Adherence Young Adult Bullying Psychological Distress |
| url | http://purl.org/au-research/grants/nhmrc/1173043 http://hdl.handle.net/20.500.11937/93184 |