Cultural Transformation and HIV Stigma among Adolescents: Exploring the Role of Social Support in a Multilevel Context (A Systematic Review)

This study aims to examine the relationship between cultural transformation and social stigma among adolescents living with HIV through a systematic review of recent international literature. The main focus includes the various forms of stigma experienced by adolescents, the role of social support from family, peers, and schools, and the effectiveness of multilevel interventions in mitigating the impact of stigma on adolescent well-being. Literature searches were conducted in the Scopus database using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, with inclusion criteria covering English-language publications from 2019 to 2025. A total of 40 articles met the eligibility criteria and were analyzed using a narrative–thematic approach. The synthesis reveals that cultural transformation influences a shift in stigma from overt to internalized forms, with shame and social withdrawal emerging as dominant expressions. Social support plays a crucial role in reducing internalized stigma and improving adherence to antiretroviral therapy. Meanwhile, multilevel interventions integrating psychosocial therapy, peer support, and inclusive school policies are identified as the most effective strategies for enhancing adolescent well-being. The study concludes that efforts to reduce stigma among adolescents living with HIV must consider the dynamic cultural contexts and involve cross-level support from families, schools, and communities.