High prevalence of depression symptomology among adolescents in Soweto, South Africa associated with being female and cofactors relating to HIV transmission

“As a Young Pregnant Girl… The Challenges You Face”: Exploring the Intersection Between Mental Health and Sexual and Reproductive Health Amongst Adolescent Girls and Young Women in South Africa

“…It is likely that after encountering a stressor, adolescents will experience stress and symptoms of depression and anxiety [13]. The stress related to the discovery of an unexpected pregnancy is compounded by the shame and social stigmatisation of teenage pregnancy, and the ensuring social isolation from family and community increases the risk for psychological distress [7]. The framing of pregnancy during adolescence as a social problem means that pregnant teens receive limited social support, which in turn is linked to poor mental health outcomes [2].…”

“…As with HIV, South Africa also has high rates of teenage pregnancy; in 2016, 16% of females aged 15–18 years had begun childbearing [ 6 ]. AGYW in South Africa are more susceptible to depressive symptoms than their male counterparts, and are likely to remain under-diagnosed and untreated [ 7 – 9 ]. Thus, their vulnerability lies at a biological, social, and environmental nexus.…”

“…Estimates suggest that approximately three quarters of mental health comorbidities that affect adults across the life course emerge during adolescence and young adulthood [ 7 ]. Adolescents’ mental health status can have profound impacts on their future health, social, and economic circumstances as adults, particularly in contexts of poverty and vulnerability [ 10 ].…”

“…The immense physical, neurocognitive, mental, and social changes that occur during adolescence not only affect mental health, but also influence sexual behaviour; during this period of transitioning to adulthood, adolescents are at increased risk of HIV infection [ 18 ]. The association between depressive symptoms and decreased sexual agency and decision-making power in AGYW are compounded by low self-esteem; in turn these are associated with increased risk behaviours, including increased susceptibility to pressure to have sex, comfort seeking, condomless sex, transactional sex, trans-generational sex, substance use, and ‘unintended’ pregnancy [ 7 , 8 , 19 – 21 ]. Some of the mechanisms through which poor mental health symptoms influence sexual risk include substance use, maladaptive coping mechanisms to deal with stress, and impaired decision-making, indicating poor mental health as a prospective predictor of sexual risk [ 22 ].…”

Suubi4Her: a study protocol to examine the impact and cost associated with a combination intervention to prevent HIV risk behavior and improve mental health functioning among adolescent girls in Uganda

“…Alongside these risks exist mental health challenges associated with economically motivated sex (both age-disparate and transactional), which have been shown to have a bi-directional relationship with depression, low self- esteem, and anxiety for young women [ 12 , 13 ]. Moreover, higher depression among young females has been associated with co-factors of HIV risk [ 14 ]. Given the heightened risk for HIV infection in adolescent girls, there is an urgent need to address the complex and multilayered economic and psychosocial issues facing this population in SSA.…”