Preventing mental health conditions in adolescents living with HIV: an urgent need for evidence

Abstract

Introduction As adolescents transition from childhood to adulthood, they experience major physical, social and psychological changes, and are at heightened risk for developing mental health conditions and engaging in health‐related risk behaviours. For adolescents living with HIV (ALHIV), these risks may be even more pronounced. Research shows that this population may face additional mental health challenges related to the biological impact of the disease and its treatment, the psychosocial burdens of living with HIV and HIV‐related social and environmental stressors. Discussion Psychosocial interventions delivered to adolescents can promote positive mental health, prevent mental health problems and strengthen young people’s capacity to navigate challenges and protect themselves from risk. It is likely that these interventions can also benefit at‐risk populations, such as ALHIV, yet there is little research on this. There is an urgent need for more research evaluating the effects of interventions designed to improve the mental health of ALHIV. We highlight four priorities moving forward. These include: generating more evidence about preventive mental health interventions for ALHIV; including mental health outcomes in research on psychosocial interventions for ALHIV; conducting intervention research that is sensitive to differences among ALHIV populations and involving adolescents in intervention design and testing. Conclusions More robust research on promotive and preventive mental health interventions is needed for ALHIV. Programmes should be informed by adolescent priorities and preferences and responsive to the specific needs of these groups.

It helps to talk: A guiding framework (TRUST) for peer support in delivering mental health care for adolescents living with HIV

“…In rural settings mental health care is largely delivered by a very small cohort of mental health nurses [ 17 ]. Given the lack of existing mental health resources and the urgency and scale of the unmet need, we need to look for alternative mechanisms through which the problem can be addressed [ 14 , 18 ].…”

Relationships with caregivers and mental health outcomes among adolescents living with HIV: a prospective cohort study in South Africa

“…There is, however, limited evidence that can inform effective mental health provision for ALHIV in the region. A set of global systematic reviews supported by the World Health Organization and UNICEF Helping Adolescents Thrive collaboration identified only three randomised controlled trials with ALHIV evaluating interventions to promote mental health, two of which were conducted in sub-Saharan Africa [ 16 , 17 ], including only one intervention focused on adolescent-caregiver relationships [ 18 ].…”

Relationships with caregivers and mental health outcomes among adolescents living with HIV: A prospective cohort study in South Africa

“…There is, however, limited evidence that can inform effective mental health provision for ALHIV in the region. A set of global systematic reviews supported by the World Health Organization and UNICEF Helping Adolescents Thrive collaboration identified only three randomised controlled trials with ALHIV evaluating interventions to promote mental health, two of which were conducted in sub-Saharan Africa (16,17), including only one intervention focused on adolescent-caregiver relationships (18). Furthermore, while experimental studies provide insights into the overall effects of interventions (19), programme evaluations often do not examine how specific components or experiences may be linked to adolescent mental health.…”