Mental health challenges among adolescents living with HIV

Vreeman, Rachel C.; McCoy, Brittany; Lee, Sonia

doi:10.7448/ias.20.4.21497

Cited by 250 publications

(266 citation statements)

References 86 publications

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“…These findings highlight the need for additional attention to the mental health needs of children and adolescents living with HIV and integration of mental health services into paediatric HIV treatment programmes. While data on the prevalence of MSDs among children and adolescents living with HIV in LMICs are limited, research indicates that children and adolescents living with HIV experience increased risk of MSDs compared to non‐infected peers . Similar to adults, MSDs among children and adolescents are associated with suboptimal HIV treatment outcomes .…”

Section: Discussionmentioning

confidence: 99%

Screening and management of mental health and substance use disorders in HIV treatment settings in low‐ and middle‐income countries within the global IeDEA consortium

et al. 2018

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IntroductionIntegration of services to screen and manage mental health and substance use disorders (MSDs) into HIV care settings has been identified as a promising strategy to improve mental health and HIV treatment outcomes among people living with HIV/AIDS (PLWHA) in low‐ and middle‐income countries (LMICs). Data on the extent to which HIV treatment sites in LMICs screen and manage MSDs are limited. The objective of this study was to assess practices for screening and treatment of MSDs at HIV clinics in LMICs participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium.MethodsWe surveyed a stratified random sample of 95 HIV clinics in 29 LMICs in the Caribbean, Central and South America, Asia‐Pacific and sub‐Saharan Africa. The survey captured information onsite characteristics and screening and treatment practices for depression, post‐traumatic stress disorder (PTSD), substance use disorders (SUDs) and other mental health disorders.ResultsMost sites (n = 76, 80%) were in urban areas. Mental health screening varied by disorder: 57% of sites surveyed screened for depression, 19% for PTSD, 55% for SUDs and 29% for other mental health disorders. Depression, PTSD, SUDs and other mental health disorders were reported as managed on site (having services provided at the HIV clinic or same health facility) at 70%, 51%, 41% and 47% of sites respectively. Combined availability of screening and on‐site management of depression, PTSD, and SUDs, and other mental health disorders was reported by 42%, 14%, 26% and 19% of sites, respectively. On‐site management of depression and PTSD was reported significantly less often in rural as compared to urban settings (depression: 33% and 78% respectively; PTSD: 24% and 58% respectively). Screening for depression and SUDs was least commonly reported by HIV programmes that treated only children as compared to HIV programmes that treated only adults or treated both adults and children.ConclusionsSignificant gaps exist in the management of MSDs in HIV care settings in LMICs, particularly in rural settings. Identification and evaluation of optimal implementation strategies to scale and sustain integrated MSDs and HIV care is needed.

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Section: Discussionmentioning

confidence: 99%

Screening and management of mental health and substance use disorders in HIV treatment settings in low‐ and middle‐income countries within the global IeDEA consortium

et al. 2018

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“…Depression and anxiety change over time and studies examining such conditions at a single time point will not represent their course and progression [11]. Although an overwhelming majority of cross-sectional studies have demonstrated the prevalence and related factors of depression and anxiety among people living with HIV, the results have been fragmentary and inconsistent [12][13][14][15]. Findings of the few existing longitudinal studies have also been mixed [16][17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal trajectories of emotional problems and unmet mental health needs among people newly diagnosed with HIV in China

et al. 2019

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Introduction Concern over mental health morbidity affecting people living with HIV is increasing worldwide. The objective of this study was to describe the longitudinal trajectories of depression and anxiety, and mental health service utilization among people newly diagnosed with HIV. Methods This was an observational cohort study that enrolled people newly diagnosed with HIV consecutively and followed them for one year in Changsha, China. Socio‐demographic, clinical and psychological data were collected at the baseline and at one‐year follow‐up. Participants were recruited between March 1, 2013 and September 30, 2014. The final follow‐up was in September 30, 2015. Results Among 557 people newly diagnosed with HIV enrolled at the baseline, 410 (73.6%) completed the one‐year follow‐up survey (median (interquartile range) age at follow‐up: 29 (25, 39) years; 376 men (91.7%)), and were included in the analysis. 39.3% and 30.2% of the 410 participants were screened with significant symptoms of depression and anxiety at baseline respectively. An overall drop in the prevalence of each condition was found at follow‐up, however, 10.5% and 6.1% of participants were found to have persistent depression and anxiety. The results of mixed‐effect models showed that bisexuality, homosexual transmission, other clinical symptoms (for example, not on antiretroviral therapy (ART)), non‐disclosure, higher levels of HIV/AIDS‐related stress, and lack of social support were associated with significant symptoms of depression and anxiety. One year after diagnosis, 8.3% had visited healthcare providers for emotional or psychological problems. Conclusions Despite the obvious need people newly diagnosed with HIV in China rarely seek professional help. Integrating depression and anxiety screening and referral into HIV care settings is warranted.

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“…This review is subject to the following limitations: 1) key population groups such as LGTBQI, sex workers and injecting drug users were excluded, as their lived experiences are likely to be different given the higher levels of stigma they possibly encounter relative to the general population of YPL-HIV [149][150][151]; 2) several applicable regional conferences lack online abstract and thus our review may have missed potentially relevant material; 3) our review focused only on YPLHIV in SSA and thus findings may not be generalisable to other regions. However, results from recent studies suggest that there are similarities between YPLHIV in SSA and other developing nations within the South-East Asia Region and Region of the Americas in terms of correlates of mental illness [81,152] and adherence [153,154]. Hence, results could be relevant to settings with similar disease and socioeconomic profiles.…”

Section: Discussionmentioning

confidence: 99%

Informing the measurement of wellbeing among young people living with HIV in sub-Saharan Africa for policy evaluations: a mixed-methods systematic review

Govindasamy

Seeley

Olaru

et al. 2020

Health Qual Life Outcomes

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Young people living with HIV (YPLHIV) in sub-Saharan Africa (SSA) are at high risk of having a poor quality of life. Addressing wellbeing explicitly within HIV/AIDS policies could assist mitigation efforts. However, guidance on wellbeing measures to evaluate policies for YPLHIV is scarce. The aims of this mixed-methods review were to identify: i) key dimensions of wellbeing and ii) wellbeing measures that align to these dimensions among YPLHIV (15-24 years) in SSA. We searched six social science and medical databases, including grey literature. We included studies that examined correlates and lived experiences of wellbeing, among YPLHIV in SSA, from January 2000 to May 2019. Two reviewers independently screened abstracts and full texts and assessed methodological quality of included articles. We analysed quantitative and qualitative data using descriptive and meta-ethnographic approaches, respectively. Thereafter, we integrated findings using a framework approach. We identified 6527 citations. Of these, 10 quantitative and 30 qualitative studies were included. Being male, higher educational status, less stigma and more social support were likely correlates of wellbeing. Themes that shaped experiences suggestive of wellbeing were: 1) acceptance and belonging-stigma, social support; 2) coping; 3) standard of living. Our final synthesis found that the following dimensions potentially characterise wellbeing: self-acceptance, belonging, autonomy; positive relations, environmental mastery, purpose in life. Wellbeing for YPLHIV is multi-dimensional and relational. Relevant measures include the Personal Wellbeing Index, Ryff's Psychological Wellbeing Scale and Mental Health Continuum Short Form. However, psychometric evaluations of these scales among YPLHIV in SSA are needed.

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Mental health challenges among adolescents living with HIV

Cited by 250 publications

References 86 publications

Screening and management of mental health and substance use disorders in HIV treatment settings in low‐ and middle‐income countries within the global IeDEA consortium

Screening and management of mental health and substance use disorders in HIV treatment settings in low‐ and middle‐income countries within the global IeDEA consortium

Longitudinal trajectories of emotional problems and unmet mental health needs among people newly diagnosed with HIV in China

Informing the measurement of wellbeing among young people living with HIV in sub-Saharan Africa for policy evaluations: a mixed-methods systematic review

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