---
title: "Co-occurring community stigmas and associations with HIV testing, mental health, and substance use"
id: "pubmed-42289791"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42289791"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42289791/"
doi: "10.1071/SH26038"
published_at: "2026-08-17T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Co-occurring community stigmas and associations with HIV testing, mental health, and substance use
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42289791
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42289791/)
- **DOI:** [10.1071/SH26038](https://doi.org/10.1071%2FSH26038)
- **Published At:** 2026-08-17T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This study examined how perceived community stigmas—toward **HIV**, **sexual/gender minority** status, and **substance use**—co-occur and relate to mental health and substance use among adolescents and young adults in Almaty, Kazakhstan. - Data came from 216 youth not diagnosed with HIV (116 female, 110 male). Multidimensional latent class analysis identified distinct stigma typologies. - Four latent classes were identified: Class 1 (low stigma across types; 26%, n = 56); Class 2 (low HIV stigma, moderate substance use and sexual/gender minority stigmas; 44%, n = 95); Class 3 (moderate HIV and sexual/gender minority stigmas, low substance use stigma; 9%, n = 19); and Class 4 (high levels of all stigma types; 21%, n = 46). - Youth in Class 4 (high all stigmas) had higher odds of self-identifying as a **sexual/gender minority** compared with Class 1 (OR 2.70; 95% CI: 1.09, 6.69). - Class 4 reported greater symptoms of depression (mean 13.88, SD 7.52) and anxiety (mean 9.00, SD 6.82) than Class 1 (depression mean 9.00, SD 6.01; anxiety mean 5.2, SD 5.38). - Youth in Class 2 were more likely to use tobacco (OR 2.47; 95% CI: 1.23, 4.93) and alcohol (OR 2.06; 95% CI: 1.05, 4.06) than those in Class 1. - The authors conclude that discrete typologies of co-occurring perceived community stigmas are differentially associated with mental health and substance use outcomes, supporting the need for interventions that address multiple, overlapping stigmas among youth in low- and middle-income settings.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA. * 2 School of Social Work, Columbia University, New York, NY, USA. * 3 Community Health Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA. * 4 Global Health Research Center of Central Asia, Almaty, Kazakhstan. * 5 Asfendiyarov Kazakh National Medical University, Department of Epidemiology, Almaty, Kazakhstan. * 6 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA. * PMID: **42289791** * DOI: [ 10.1071/SH26038 ](https://doi.org/10.1071/sh26038) Item in Clipboard # Co-occurring stigmas and associations with HIV testing, mental health, and substance use: a latent class analysis among youth in Kazakhstan Sam D Gardner et al. Sex Health. 2026. Show details Display options Display options Format Abstract PubMed PMID Sex Health Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Sex+Health%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Sex+Health%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42289791/) . 2026 Aug 17;23(4):SH26038. doi: 10.1071/SH26038. ### Authors [Sam D Gardner](https://pubmed.ncbi.nlm.nih.gov/?term=Gardner+SD&cauthor_id=42289791)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42289791/#short-view-affiliation-1 "Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42289791/#short-view-affiliation-2 "School of Social Work, Columbia University, New York, NY, USA."), [Andrea Norcini Pala](https://pubmed.ncbi.nlm.nih.gov/?term=Norcini+Pala+A&cauthor_id=42289791)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42289791/#short-view-affiliation-3 "Community Health Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA."), [Jeremy Kane](https://pubmed.ncbi.nlm.nih.gov/?term=Kane+J&cauthor_id=42289791)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42289791/#short-view-affiliation-1 "Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA."), [Gaukhar Mergenova](https://pubmed.ncbi.nlm.nih.gov/?term=Mergenova+G&cauthor_id=42289791)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42289791/#short-view-affiliation-4 "Global Health Research Center of Central Asia, Almaty, Kazakhstan.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42289791/#short-view-affiliation-5 "Asfendiyarov Kazakh National Medical University, Department of Epidemiology, Almaty, Kazakhstan."), [Olga Balabekova](https://pubmed.ncbi.nlm.nih.gov/?term=Balabekova+O&cauthor_id=42289791)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42289791/#short-view-affiliation-4 "Global Health Research Center of Central Asia, Almaty, Kazakhstan."), [Denis Gryazev](https://pubmed.ncbi.nlm.nih.gov/?term=Gryazev+D&cauthor_id=42289791)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42289791/#short-view-affiliation-4 "Global Health Research Center of Central Asia, Almaty, Kazakhstan."), [Yihang Sun](https://pubmed.ncbi.nlm.nih.gov/?term=Sun+Y&cauthor_id=42289791)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42289791/#short-view-affiliation-2 "School of Social Work, Columbia University, New York, NY, USA."), [Sara E Landers](https://pubmed.ncbi.nlm.nih.gov/?term=Landers+SE&cauthor_id=42289791)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42289791/#short-view-affiliation-6 "Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA."), [Alissa Davis](https://pubmed.ncbi.nlm.nih.gov/?term=Davis+A&cauthor_id=42289791)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42289791/#short-view-affiliation-2 "School of Social Work, Columbia University, New York, NY, USA.") ### Affiliations * 1 Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA. * 2 School of Social Work, Columbia University, New York, NY, USA. * 3 Community Health Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA. * 4 Global Health Research Center of Central Asia, Almaty, Kazakhstan. * 5 Asfendiyarov Kazakh National Medical University, Department of Epidemiology, Almaty, Kazakhstan. * 6 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA. * PMID: **42289791** * DOI: [ 10.1071/SH26038 ](https://doi.org/10.1071/sh26038) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Co-occurring perceived community stigmas (HIV, sexual/gender minority status and substance use) impact health behaviors and access to healthcare services, particularly in low- and middle-income countries, but there is a paucity of research among adolescents and young adults). This paper explores the associations between co-occurring perceived community stigmas (HIV, sexual/gender minority status and substance use) and their relationship to mental health and substance use outcomes among youth in Kazakhstan. **Methods:** Participants were 216 (females: 116, males: 110) youth living in Almaty, Kazakhstan, who were not diagnosed with HIV. We used multidimensional latent class analyses to identify groups of youth with different combinations of perceived community stigmas. **Results:** The four latent classes are: (1) low levels of all stigma types (26%, n = 56); (2) low levels of HIV stigma with moderate levels of substance use and sexual/gender minority status stigmas (44%, n = 95); (3) moderate levels of HIV and sexual/gender minority status stigmas with low substance use stigma (9%, n = 19); and (4) high levels of all stigma types (21%, n = 46). Adolescents and young adults in Class 4 had higher odds of self-identifying as a sexual/gender minority (OR 2.70; 95% CI: 1.09, 6.69) compared with Class 1. Youth in Class 4 had higher depression (M 13.88, s.d. 7.52) and anxiety (M 9.00, s.d. 6.82) compared with Class 1 (M 9.00, s.d. 6.01; M 5.2, s.d. 5.38, respectively). Youth in Class 2 were 2.47 times (95% CI: 1.23, 4.93) more likely to have used tobacco, and 2.06 times (95% CI: 1.05, 4.06) more likely to have used alcohol than Class 1. **Conclusion:** Discrete typologies of perceived co-occurring community stigmas are differentially associated with health outcomes, suggesting a need for interventions to address co-occurring stigmas. **Keywords:** HIV; Kazakhstan; LMIC; adolescents and young adults; mental health; sexual/gender minority; stigma; substance use. © 2026 The Author(s) (or their employer(s)). Published by CSIRO Publishing. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Latent class analysis of substance use typologies associated with mental and sexual health outcomes among sexual and gender minority youth. ](https://pubmed.ncbi.nlm.nih.gov/37768906/) Carney T, Choi SK, Stephenson R, Bauermeister JA, Carrico AW.Carney T, et al.PLoS One. 2023 Sep 28;18(9):e0290781. doi: 10.1371/journal.pone.0290781. eCollection 2023.PLoS One. 2023.PMID: 37768906Free PMC article. * [ A latent class analysis of the co-occurrence of sexual violence, substance use, and mental health in youth. ](https://pubmed.ncbi.nlm.nih.gov/31131676/) Nelon JL, De Pedro KT, Gilreath TD, Patterson MS, Holden CB, Esquivel CH.Nelon JL, et al.Subst Use Misuse. 2019;54(12):1938-1944. doi: 10.1080/10826084.2019.1618337. Epub 2019 May 26.Subst Use Misuse. 2019.PMID: 31131676 * [ Gender and Sexual Identities Predicting Patterns of Co-occurring Health Risks Among Sexual Minority Youth: a Latent Class Analysis Approach. ](https://pubmed.ncbi.nlm.nih.gov/32529419/) Srivastava A, Davis JP, Goldbach JT.Srivastava A, et al.Prev Sci. 2020 Oct;21(7):908-916. doi: 10.1007/s11121-020-01137-z.Prev Sci. 2020.PMID: 32529419 * [ Stigmas experienced by sexual and gender minority people with HIV in the Dominican Republic: a qualitative study. ](https://pubmed.ncbi.nlm.nih.gov/39688954/) Budhwani H, Ruiz De León I, Waters J, Nash P, Bond CL, Varas-Díaz N, Naar S, Nyblade L, Paulino-Ramírez R, Turan JM.Budhwani H, et al.Ann Behav Med. 2025 Jan 4;59(1):kaae073. doi: 10.1093/abm/kaae073.Ann Behav Med. 2025.PMID: 39688954Free PMC article. * [ Health disparities in one of the world's most progressive countries: a scoping review of mental health and substance use among sexual and gender minority people in the Netherlands. ](https://pubmed.ncbi.nlm.nih.gov/38110908/) Hughes TL, Bochicchio L, Drabble L, Muntinga M, Jukema JS, Veldhuis CB, Bruck S, Bos H.Hughes TL, et al.BMC Public Health. 2023 Dec 18;23(1):2533. doi: 10.1186/s12889-023-17466-x.BMC Public Health. 2023.PMID: 38110908Free PMC article. 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