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This study examines HIV disclosure and enacted stigma among adolescents and young adults living with HIV in South Africa. This study uses survey data from a sample of 1186 youth living with HIV, aged 14\u201324, and enrolled in peer support groups led by community-based organizations in KwaZulu Natal and Gauteng provinces, South Africa. Study participants completed a questionnaire on sociodemographic details, physical health, school attendance, who knew the individual\u2019s HIV status, and experiences of HIV-related mistreatment. Mixed effects logistic regression examined the association between experiences of HIV-related mistreatment and factors that may inadvertently disclose one\u2019s status, such as poor physical health and missed school, and knowledge of an individual\u2019s HIV-positive status by their caregiver, household, friends, educators, and most recent sexual partner. Almost a quarter of the sample reported an experience of HIV-related mistreatment in the past six months. After controlling sociodemographic characteristics, missed school due to illness (AOR\u2009=\u20091.75, 95% CI\u2009=\u20091.27\u20132.43), and knowledge of HIV status by non-family members (AOR\u2009=\u20092.19, 95% CI\u2009=\u20091.60-3.00) were significantly associated with HIV-related mistreatment. Findings suggest that experiences of enacted stigma are common among youth and linked to poor physical health and knowledge of HIV status outside the family. Effective community-level stigma reduction interventions are urgently needed. In the meantime, adolescents need individualized disclosure counseling and support managing their physical health to prevent further inadvertent disclosure and discrimination.<\/jats:p>","DOI":"10.1007\/s10461-024-04487-9","type":"journal-article","created":{"date-parts":[[2024,9,8]],"date-time":"2024-09-08T23:09:12Z","timestamp":1725836952000},"page":"4158-4166","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Disclosure and Experiences of HIV-Related Stigma among Adolescents and Young Adults Living with HIV in South Africa"],"prefix":"10.1007","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0118-3489","authenticated-orcid":false,"given":"Johanna","family":"Nice","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonya R.","family":"Thurman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Luckett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babalwa","family":"Zani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,9]]},"reference":[{"key":"4487_CR1","unstructured":"UNICEF. 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