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Although there has been limited investigation of stigma and long-term outcomes, stigma may have clear downstream effects, such as reduced treatment adherence and heightened psychosocial distress [24, 28]

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Aggregation and Analysis For aggregation, we use the Mazziotta-Pareto Index (MPI) (De Muro et al., 2011), a non-compensatory technique specifically developed for indices of multifaceted social phenomena