Prospective associations between bullying victimisation, internalised stigma, and mental health in South African adolescents living with HIV

Abstract Background Mental health problems may impact adherence to anti-retroviral treatment, retention in care, and consequently the survival of adolescents living with HIV. The adolescent-caregiver relationship is an important potential source of resilience. However, there is a lack of longitudinal research in sub-Saharan Africa on which aspects of adolescent-caregiver relationships can promote mental health among adolescents living with HIV. We draw on a prospective longitudinal cohort study undertaken in South Africa to address this question. Methods The study traced adolescents aged 10–19 initiated on antiretroviral treatment in government health facilities (n = 53) within a health district of the Eastern Cape province. The adolescents completed standardised questionnaires during three data collection waves between 2014 and 2018. We used within-between multilevel regressions to examine the links between three aspects of adolescent-caregiver relationships (caregiver supervision, positive caregiving, and adolescent-caregiver communication) and adolescent mental health (depression symptoms and anxiety symptoms), controlling for potential confounders (age, sex, rural/urban residence, mode of infection, household resources), n=926 adolescents. Results Improvements in caregiver supervision were associated with reductions in anxiety (0.98, 95% CI 0.97–0.99, p=0.0002) but not depression symptoms (0.99, 95% CI 0.98–1.00, p=.151), while changes in positive caregiving were not associated with changes in mental health symptoms reported by adolescents. Improvements in adolescent-caregiver communication over time were associated with reductions in both depression (IRR=0.94, 95% CI 0.92–0.97, p<.0001) and anxiety (0.91, 95% CI 0.89–0.94, p<.0001) symptoms reported by adolescents. Conclusions Findings highlight open and supportive adolescent-caregiver communication and good caregiver supervision as potential factors for guarding against mental health problems among adolescents living with HIV in South Africa. Several evidence-informed parenting programmes aim to improve adolescent-caregiver communication and caregiver supervision, and their effect on depression and anxiety among adolescents living with HIV should be rigorously tested in sub-Saharan Africa. How to improve communication in other settings, such as schools and clinics, and provide communication support for caregivers, adolescents, and service providers through these existing services should also be considered.

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Addressing the mental health needs of adolescents in South African communities: a protocol for a feasibility randomized controlled trial

Pilot and Feasibility Studies ◽

10.1186/s40814-021-00803-5 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

K. Sorsdahl ◽

C. van der Westhuizen ◽

M. Neuman ◽

H. A. Weiss ◽

B. Myers

Keyword(s):

Mental Health ◽

At Risk ◽

South African ◽

Mental Health Problems ◽

Age Of Onset ◽

Common Mental Disorders ◽

Controlled Trial ◽

Feasibility Trial ◽

Counselling Intervention ◽

Health Counselling

Abstract Background Like many low- and middle-income countries, almost half of the proportion of the South African population is under the age of 25. Given the peak age of onset for most mental health problems is in adolescence, it is vital that adolescents have access to mental health counselling. There are several initiatives to increase access to mental health counselling in South Africa, primarily through the integration of counselling for common mental disorders (CMD) into primary health care services, but adolescents (15–18 years of age) generally do not utilize these services. To address this gap, we will undertake a study to explore the feasibility of conducting a trial of the effectiveness of a community-based mental health counselling intervention for adolescents at-risk for a CMD. Methods The study is a feasibility trial of the ASPIRE intervention, a four-session blended multi-component counselling intervention adapted for South African adolescents at risk for depression and alcohol use disorders. We will enrol 100 adolescents from community settings and randomly assign them to the ASPIRE intervention or a comparison condition. Feasibility measures, such as rates of recruitment, consent to participate in the trial and retention, will be calculated. Qualitative interviews with participants and counsellors will explore the acceptability of the intervention. The primary outcomes for a subsequent trial would be reductions in symptoms of depression and days of heavy drinking which will be measured at baseline, 6 weeks, and 3 months post-randomization. Discussion This feasibility trial using a mixed-methods design will allow us to determine whether we can move forward to a larger effectiveness trial of the ASPIRE intervention. Trial registration The trial is registered with the Pan African Clinical Trials Registry (PACTR20200352214510). Registered 28 February 2020—retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9795

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Interactions Between Mental Health And Socioeconomic Status In The South African National Income Dynamics Study

Studies in Economics and Econometrics ◽

10.1080/10800379.2010.12097210 ◽

2010 ◽

Vol 34 (3) ◽

pp. 69-85 ◽

Cited By ~ 4

Author(s):

C Ardington ◽

A Case

Keyword(s):

Mental Health ◽

Socioeconomic Status ◽

South African ◽

National Income ◽

Income Dynamics ◽

The South

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Gender, Mental Health, and Entry Into Care with Advanced HIV Among People Living with HIV in Cameroon Under a National ‘Treat All’ Policy

AIDS and Behavior ◽

10.1007/s10461-021-03328-3 ◽

2021 ◽

Author(s):

Angela M. Parcesepe ◽

Lindsey M. Filiatreau ◽

Peter Vanes Ebasone ◽

Anastase Dzudie ◽

Rogers Ajeh ◽

...

Keyword(s):

Mental Health ◽

People Living With Hiv ◽

Treat All ◽

Living With Hiv

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Gendered Experiences of Living with HIV in Australia

Sexes ◽

10.3390/sexes2030020 ◽

2021 ◽

Vol 2 (3) ◽

pp. 244-255

Author(s):

Vicki Hutton

Keyword(s):

Mental Health ◽

Lived Experience ◽

Case Reports ◽

Economic Status ◽

Geographic Location ◽

Geographic Region ◽

Gender And Sexuality ◽

Economic Consequences ◽

People Living With Hiv ◽

Living With Hiv

Globally, women represent more than half the people living with HIV. This proportion varies by country, with an over-representation of HIV among men who have sex with men (MSM) in some regions. For example, in Australia, MSM account for over 60% of transmissions, with heterosexual sex accounting for almost a quarter of transmissions. Irrespective of geographic region, there is evidence that women can have a different lived experience of HIV due to their unequal social and economic status in society, while MSM can have a different lived experience depending on the laws and customs of their geographic location. Gender differences related to risk factors, stigma, access to services, mental health, health-related quality of life and economic consequences have been consistently reported globally. This paper explores the subjective lived experience of gender and sexuality disparities among three individuals living with HIV in Australia: a male who identified as gay, and a male and female who each identified as heterosexual. Analysis of themes from these three case reports indicated discernible differences by gender and sexuality in four areas: access to medical services, social support, stigma and mental health. It is argued that knowledge and understanding of potential gender and sexuality disparities must be factored into supportive interventions for people living with HIV in Australia.

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Towards an AIDS-free generation by 2030: how are South African children, adolescents, caregivers and health care workers coping with HIV?

South African Journal of Psychology ◽

10.1177/0081246321992175 ◽

2021 ◽

pp. 008124632199217

Author(s):

Yogan Pillay

Keyword(s):

Health Care ◽

Children And Adolescents ◽

South African ◽

Health Care Workers ◽

Policy Makers ◽

Number Of Children ◽

Key Stakeholders ◽

Care Workers ◽

Free Generation ◽

Living With Hiv

We are committed to an AIDS free generation by 2030 – nine short years away. This article reflects on the global and South African data on new infections, total number of children and adolescents living with HIV as well as data on vertical transmission. The article includes the voices of key stakeholders in the quest to end HIV in children so that lessons from their experiences can be used by policy makers in strengthening services.

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