The impact of intergenerational transmission of stigma on the psychological development of minors with HIV-positive parents

With the widespread adoption of antiretroviral therapy, HIV infection has become a chronic, manageable condition, and the population of HIV-positive parents continues to grow. The stigma linked to their condition passes down to their minor children within the family. This harms the children’s mental health and makes it harder to prevent and control HIV. This review explores the patterns and mechanisms of intergenerational transmission. It uses stigma theory and ecological systems theory. By examining evidence from around the world and within China, it highlights transmission features and how to adapt interventions specifically for the Chinese context. The results indicate that the stigma experienced by HIV-positive parents exhibits three-dimensional overlap, role specificity, and chronic persistence, with significant population heterogeneity. Intergenerational transmission happens through a four-level chain. It includes family communication and disclosure, parent–child attachment, and family functioning. Next, parental emotions and behaviors come into play. Finally, children’s understanding and internalisation of stigma follow. This process shows a dose–response relationship with psychological harm in children. Among existing interventions, family-system-integrated interventions yield the best outcomes, supplemented by individual parental interventions, child protection measures, and social structural interventions; these must be adapted to local cultural and population characteristics. The study shows that we can intervene in the intergenerational passing of disease-related shame. Future research should include longitudinal studies, focus on specific populations, and develop multi-system collaborative intervention models to safeguard the rights of affected children and improve the comprehensive HIV/AIDS prevention and control system.