{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T03:08:25Z","timestamp":1788750505443,"version":"build-2803163510"},"reference-count":57,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["Project Grant: 479681"],"award-info":[{"award-number":["Project Grant: 479681"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Stigma is multidimensional and undermines HIV care. We examined socio\u2010environmental pathways linking HIV\u2010related stigma, everyday discrimination and structural stigma to antiretroviral therapy (ART) adherence among men who have sex with men (MSM) and female sex workers (FSW) living with HIV in Kampala, Uganda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional survey (06\/2024\u201302\/2025) among MSM and FSW aged 18\u201335 receiving HIV services from a key population clinic in Kampala. ART adherence was assessed using the Wilson 3\u2010item adherence scale. We conducted stratified multivariable linear regression and multi\u2010group structural equation modelling (SEM) to estimate direct and indirect associations from stigma to adherence through socio\u2010environmental stressors (traumatic exposure severity to extreme weather [TESS], food insecurity, water insecurity), adjusted for socio\u2010demographic variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants included MSM (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009225, mean age: 27.65, standard deviation [SD]\u2009=\u20093.54) and FSW (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009240, mean age: 25.68, SD: 2.90). SEM showed acceptable fit. In adjusted SEM analyses (a) among MSM, higher TESS, HIV\u2010related stigma and everyday discrimination were directly associated with lower ART adherence and (b) among FSW, higher TESS, HIV\u2010related stigma, water and food insecurity were directly associated with lower ART adherence. There were significant indirect associations between HIV\u2010related stigma and ART adherence via TESS for FSW and MSM, and between everyday discrimination and structural stigma with ART adherence via TESS for MSM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Stigma and socio\u2010environmental stressors, including traumatic exposure to extreme weather events, were associated with reduced ART adherence among MSM and FSW participants. Population\u2010tailored HIV care interventions may benefit from integrating intersectional stigma reduction with economic and disaster preparedness supports.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70275","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T02:46:19Z","timestamp":1783133179000},"page":"1503-1516","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Examining pathways between stigma, extreme weather exposure, resource insecurities and\n                    <scp>ART<\/scp>\n                    adherence among young men who have sex with men and female sex workers living with\n                    <scp>HIV<\/scp>\n                    in\n                    <scp>Kampala, Uganda<\/scp>"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8035-433X","authenticated-orcid":false,"given":"Carmen 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