Mental Health Problems Experienced by HIV Positive Adolescents; A Case of Choma District, Zambia

Abstract

Several scholars have reported high mental health problems among adolescents with Human Immunodeficiency Virus (HIV) globally. However, little is known about the mental health of this peculiar group of young people in Choma district. This study aimed to determine the mental health problems experienced by HIV positive adolescents in Choma District. Using the Strengths and Difficulties Questionnaire (SDQ), data were obtained from 103 HIV positive adolescents receiving treatment at Choma General Hospital plus a corresponding number of parents/care givers. Information about mental health services was obtained qualitatively from 10 nurses working in the mental health unit and the Antiretroviral (ART) clinic. The results showed that more than three quarters of the adolescents had mental health problems. Of this number, 57.3 percent had multiple mental health problems: predominantly emotional and peer problems. The study also found a statistically significant relationship between level of stigma and presence of mental health problems (X 2 = 1.123, P = 0.003). In conclusion, the study demonstrated that multiple mental health problems particularly emotional and peer problems are prevalent among adolescents with HIV/AIDS yet are most often undiagnosed. In addition, adolescents with high levels of internalized stigma are more likely to have multiple mental health problems. The findings suggest the need to integrate psychiatric services into routine care of HIV infected adolescents, routine screening for mental health problems and provision of continued professional development among nurses managing these patients.

The prevalence of mental health problems in sub-Saharan adolescents living with HIV: a systematic review

“…Four studies reported emotional and behavioral difficulties, assessed by the Strengths and Difficulties Questionnaire (SDQ) (Menon et al ., 2009 ; Vreeman et al ., 2015 ; Gentz et al ., 2017 ; Lyambai and Mwape, 2018 ). The lowest prevalence was reported by Vreeman et al ., from a sample of younger adolescents ( n = 285; age 10–14) enrolled in a disclosure intervention trial in Kenya (Vreeman et al ., 2015 ): 9% scored in the borderline range and 5% in the clinical range.…”

“…Two other studies, conducted in Zambia ( n = 99; age 12–18) and Namibia ( n = 127; age 11–15), reported a prevalence of 28.5% and 29.1% for emotional and behavioral problems (borderline and clinical range) (Menon et al ., 2009 ; Gentz et al ., 2017 ). Another study from Zambia ( n = 103; age 11–17) reported on the percentage that scored in the clinical range (29.2%) (Lyambai and Mwape, 2018 ). Menon et al ., compared a sample of HIV-positive adolescents ( n = 127) to a sample of school children ( n = 420) (Menon et al ., 2009 ) and found a comparable prevalence of emotional and behavioral problems (29.1 v. 27.8%).…”

“…Menon et al ., compared a sample of HIV-positive adolescents ( n = 127) to a sample of school children ( n = 420) (Menon et al ., 2009 ) and found a comparable prevalence of emotional and behavioral problems (29.1 v. 27.8%). Three studies also reported results for the different subscales of the SDQ (Menon et al ., 2009 ; Gentz et al ., 2017 ; Lyambai and Mwape, 2018 ): In the sample from Namibia (Gentz et al ., 2017 ), emotional problems were more prevalent (22%) than conduct problems (12.2%), peer problems (10.9%) or hyperactivity/inattention (4%). The two other studies, both from Zambia, found a higher frequency of peer problems (46.9% and 41.8%, respectively), compared to emotional or conduct problems (Menon et al ., 2009 ; Lyambai and Mwape, 2018 ).…”

“…Differences between self-and caregiver-report were described in two of the studies (Lyambai and Mwape, 2018;Kinyanda et al, 2019). van den Heuvel et al (2019) explored agreement and discrepancies between caregiver-and self-reported results from the sample of Kinyanda et al, and only found a modest correlation between the two.…”

“…Peer problems were also frequent in the sample of unaffected school children that was used as a control group (34.4%). Lyambai and Mwape compared self-rated results to parent-rated results and found that parents reported fewer problems in each of the categories (Lyambai and Mwape, 2018) and this was most prominent for peer problems. Musisi and Kinyanda (2009) made use of the Self-Reporting Questionnaire 25 (SRQ-25) to assess significant psychological distress among a sample of HIV-positive adolescents (n = 82; age 10-18) from Uganda and reported a prevalence of 51%.…”