HIV-related stigma as a mediator between perceived social support and reasons for non-disclosure of self-HIV status among children and adolescents living with HIV

Children and adolescents living with HIV face complex decisions about disclosing their HIV status, influenced by social, emotional and contextual factors, including perceived support and experiences of stigma. This study examined the relationship between perceived social support, HIV-related stigma and motivations for non-disclosure, and assessed whether stigma mediates the link between social support and non-disclosure among young people living with HIV. A cross-sectional study was conducted with 90 participants aged 10-18 years receiving antiretroviral therapy at a tertiary hospital in northern India. Participants completed standardized measures of perceived social support, HIV-related stigma and non-disclosure motivations. Higher social support was associated with lower stigma, and greater stigma predicted stronger non-disclosure motivation. Mediation analysis showed a significant indirect effect of social support on non-disclosure through stigma, indicating partial mediation. Findings underscore the central role of stigma in disclosure decision-making. Interventions that enhance supportive relationships and reduce stigmatizing attitudes in families, schools and healthcare settings may promote healthier coping and developmentally appropriate disclosure.