Prevalence, risk and protective indicators of common mental disorders among young people living with HIV compared to their uninfected peers from the Kenyan coast: a cross-sectional study

Abstract

Background In sub-Saharan Africa, common mental disorders (CMDs) like depression and anxiety are under-investigated amongst young people living with HIV (YLWH). To address the gap, in Kenya we: a) determined the prevalence of CMDs among YLWH compared to their uninfected peers; b) investigated HIV status as an independent predictor of CMDs in young people; c) investigated CMDs risk and protective indicators with more focus on YLWH. Methods Between November 2018 and September 2019, 819 young people aged 18–24 years (407 HIV-infected) were recruited from two Counties on the Kenyan coast. Locally adapted pre-existing mental health measures, Patient Health Questionnaire (9-item) and Generalized Anxiety Disorder scale (7-item), were administered among other questionnaires via audio computer-assisted self-interview. Logistic regression was used to determine the correlates of CMDs. Results Prevalence of CMDs was significantly elevated among YLWH compared to their uninfected peers i.e. 29% vs. 12%; p < 0.001 for depressive symptoms, 19% vs. 8%; p < 0.001 for anxiety symptoms, and 16% vs. 5%; p < 0.001 for comorbid depressive and anxiety symptoms. HIV status independently predicted depressive symptoms and its co-occurrence with anxiety symptoms. Among YLWH, negative life events, higher perceived HIV-related stigma and low adherence to antiretroviral therapy were the risk indicators for elevated CMDs. Among HIV-uninfected youths, death of both parents was a risk indicator for elevated depressive symptoms. Protective indicators against CMDs among youths with and without HIV included higher social support and health-related quality of life. Conclusion At the Kenyan coast, YLWH have significantly higher burden of CMDs compared to their uninfected peers. Being HIV-positive as a youth in this setting is predictive of more depressive symptoms and its comorbidity with anxiety symptoms. YLWH at high risk of CMDs in coastal Kenya can benefit from early detection, referral and treatment if routine screening for CMDs is integrated in their care package. The mental wellbeing of bereaving HIV-unaffected youths could be improved through continued support to help them come to terms with their loss. At the community level, programmes strengthening the social capital or improving the overall quality of life of youths with or without HIV may be beneficial to their mental health.

Psychometric Properties of the Berger HIV Stigma Scale: A Systematic Review

“…The included studies recruited a total of 68,933 participants, with individual sample sizes ranging from 14 in Rwanda [ 98 ] to 2987 in China [ 187 ]. The recruited participants included diverse samples of PLWH, including adolescents and young adults living with HIV in 12 studies [ 22 , 23 , 38 , 62 , 72 , 80 , 83 , 125 , 126 , 129 , 163 , 178 ], adolescent girls and young women living with HIV in four studies [ 33 , 54 , 68 , 117 ], pregnant women living with HIV in one study [ 31 ], older women living with HIV in one study [ 151 ], older adults living with HIV in seven studies [ 44 , 61 , 63 , 77 , 81 , 139 , 161 ], women living with HIV in 19 studies [ 25 , 42 , 50 , 57 , 58 , 59 , 89 , 90 , 110 , 123 , 135 , 136 , 138 , 141 , 157 , 158 , 168 , 169 , 179 ], men living with HIV in six studies [ 46 , 75 ,…”

Alcohol and illicit drug use among young people living with HIV compared to their uninfected peers from the Kenyan coast: prevalence and risk indicators

“…Data were analyzed for 812 participants after exclusion of data from seven participants because of missing outcome data ( n = 2; one HIV-positive youth and one HIV-uninfected youth), refusal to take HIV test (HIV-uninfected youths only) which was the last step of assessment ( n = 3), or reactive HIV test ( n = 2). The study recruitment flowchart has been published [ 29 ] and is presented here as a supplementary material (see Additional file 1 ).…”

“…HIV-related characteristics of YLWH are presented here as supplementary data for ease of access (see Additional file 2 ) as these have been reported in detail [ 29 ]. In summary, their mean body mass index was within the normal range (mean [SD] = 20.6 [3.6]).…”

“…The details of the methodology have been described in another paper [ 29 ]. Between November 2018 and September 2019, a cross-sectional study was conducted along the Kenyan coast recruiting young people with and without HIV from HIV clinics and adjacent communities, respectively.…”

“…Exclusion criteria included being below 18 years or over 24 years, not providing consent for participation, unverified HIV-positive status and not being on ART. HIV-positive females whose medical records indicated they were pregnant or those who self-reported being pregnant were excluded from participation because pregnancy had the potential of impacting other study outcomes in the larger cross-sectional study as explained elsewhere [ 29 ]. Bookings for study interviews were done after participants had been taken through the study in details by research assistants present at the time of the meeting and provided written informed consent.…”