Background: Eastern and Southern Africa carries the highest global burden of HIV, and despite advances in treatment and prevention, HIV-related stigma remains a barrier to testing, disclosure and care engagement. Adolescents and young people are particularly vulnerable due to persistent misconceptions and limited access to accurate HIV information. In Mozambique one of the countries most affected by HIV discriminatory attitudes toward people living with HIV (PLHIV) remain widespread, yet evidence on stigma patterns among youth is limited.
Objective: To estimate the prevalence of discriminatory attitudes toward PLHIV among adolescents and young people aged 15–24 years in Mozambique and examine differences across sociodemographic subgroups.
Methodology: This cross-sectional analysis used data from the 2022–23 Mozambique Demographic and Health Survey (DHS), conducted between February 2022 and July 2023. The sample included 8,015 adolescents and young people aged 15–24 years. Discriminatory attitudes were defined using the standard DHS composite indicator, based on respondents' unwillingness to allow children with HIV to attend school with uninfected children or refusal to buy food from a vendor living with HIV. Weighted prevalence estimates were calculated across regions and sociodemographic characteristics. Differences between groups were assessed using the survey-adjusted Rao–Scott chi-square test, with p < 0.05 considered statistically significant.
Key Findings: One in three Mozambican youth (38.1%, 95% CI: 36.1–40.1) expressed discriminatory attitudes toward PLHIV. Prevalence was significantly higher among adolescents aged 15-19 years (41.3%, 95% CI: 38.9–43.8) compared with young adults aged 20-24 years (34.2%, 95% CI: 31.8–36.7, p < 0.01). Geographic disparities were evident: the northern region had the highest prevalence (53.5%, 95% CI: 49.7–57.3, p < 0.01), nearly double that of the southern region. Rural youth (44.6%, 95% CI: 41.9–47.4, p < 0.01) reported higher stigma than urban youth. Discriminatory attitudes were also more common among youth with no formal education (54.4%, 95% CI: 49.9–59.4), those in the poorest wealth quintile (51.1%, 95% CI: 46.7–55.4), and those with no knowledge of contraceptive methods (55.8%, 95% CI: 50.5–61.0) or sexually transmitted infections (48.9%, 95% CI: 46.2–51.7).
Policy/Programmatic Implications: Discriminatory attitudes toward PLHIV in Mozambique remain high, especially among adolescents and may hinder HIV testing uptake and treatment-seeking. These attitudes are strongly linked to low education, poverty and limited sexual and reproductive health knowledge. Targeted, youth-centered interventions are needed to reduce stigma and support progress toward national HIV goals.
Keywords: HIV Stigma, Discriminatory Attitudes, Adolescents, Young People, Mozambique, Demographic and Health Survey