Perceived stigma mediates the relationship between regional gray matter volume and aggressive behavior in children affected by parental HIV/AIDS

Perceived stigma, the subjective awareness of prejudice, stereotypes, and discrimination against persons living with HIV and their children, is a recognized predictor of behavioral problems. However, the neurobiological basis underlying perceived stigma and its role in influencing aggressive behavior at neural level in children affected by parental HIV/AIDS remain largely unclear. In this study, 112 participants aged 10-17 years from a large neurobiological project were extracted for gray matter volume (GMV) in the prefrontal cortex (PFC) and medial temporal lobe (MTL). The results revealed a significant positive correlation between parahippocampal gyrus volume and perceived stigma, after correcting for multiple comparisons. Mediation analysis further demonstrated that perceived stigma mediated the relationship between GMV in the parahippocampal gyrus and aggressive behavior. These findings support the stress acceleration hypothesis, suggesting children exposed to chronic stress accelerate neurodevelopment, particularly in the stress and emotional processing regions. Our study advances the neurostructural understanding of stigma processing and provides clinical insights for targeted interventions in this high-risk population and other marginalized children.