Anxiety and depression symptoms in young people with perinatally acquired HIV and HIV affected young people in England

ABSTRACT

Adolescents with perinatal HIV (PHIV) may be at higher risk of anxiety and depression than HIV negative young people. We investigated prevalence of anxiety and depression symptoms in 283 PHIV and 96 HIV-affected (HIV-negative) young people in England recruited into the Adolescents and Adults Living with Perinatal HIV (AALPHI) cohort. We used Hospital Anxiety and Depression Scale (HADS) scores and linear regression investigated predictors of higher (worse) scores.115 (41%) and 29 (30%) PHIV and HIV-affected young people were male, median age was 16 [interquartile range 15,18] and 16 [14,18] years and 241 (85%) and 71 (74%) were black African, respectively. There were no differences in anxiety and depression scores between PHIV and HIV-affected participants. Predictors of higher anxiety scores were a higher number of carers in childhood, speaking a language other than English at home, lower self-esteem, ever thinking life was not worth living and lower social functioning. Predictors of higher depression scores were male sex, death of one/both parents, school exclusion, lower self-esteem and lower social functioning. In conclusion, HIV status was not associated with anxiety or depression scores, but findings highlight the need to identify and support young people at higher risk of anxiety and depression.

KEYWORDS:

• Anxiety
• depression
• young people
• perinatal
• HIV

Acknowledgements

Author contributions: MLP, AA-P, DM, CF, ME, AW, DMG and AJ designed the mental health aspects of the study and conceived this analysis. MLP, KS and KR conducted study interviews. FP conducted the statistical analysis with support from AJ and DF. MLP wrote the first draft of the manuscript, with assistance from AJ. All authors contributed to the interpretation of the data, commented on the draft, and approved the final version.

We thank all the young people, parents and staff from all the clinics and voluntary services in AALPHI.

Project team: S. Brice, A. Judd, M. Le Prevost, A. Mudd, F. Parrott, K. Rowson, K. Sturgeon.

Investigators: M. Conway, K. Doerholt, D. Dunn, C. Foster, D.M. Gibb, A. Judd (PI), S. Kinloch, N. Klein, H. Lyall, D. Melvin, K. Prime, C. Sabin, M. Sharland, C. Thorne, P. Tookey.

MRCC CTU Data Services: C. Diaz Montana, K. Fairbrother, M. Rauchenberger, N. Tappenden, S. Townsend.

Steering Committee chairs: D. Gibb, D. Mercey (2012–2015), C. Foster (2016-).

Patient and public involvement: Children’s HIV Association Youth Committee.

NHS clinics (named alphabetically): LONDON: Chelsea and Westminster NHS Foundation Trust, F. Boag, P. Seery; Great Ormond Street Hospital NHS Foundation Trust, M. Clapson, V. Noveli; Guys and St Thomas’ NHS Foundation Trust, A. Callaghan, E. Menson; Imperial College Healthcare NHS Trust, C. Foster, A. Walley; King’s College Hospital NHS Foundation Trust, E. Cheserem, E. Hamlyn; Mortimer Market Centre, Central and North West London NHS Foundation Trust, R. Gilson, T. Peake; Newham University Hospital, S. Liebeschuetz; North Middlesex University Hospital NHS Trust, J. Daniels; Royal Free London NHS Foundation Trust, T. Fernandez, S. Kinloch de Loes; St George’s University Hospitals NHS Foundation Trust, S. Storey, K. Prime. REST OF ENGLAND: Alder Hey Children’s NHS Foundation Trust, S. Paulus, A. Riordan; Birmingham Heartlands, Heart of England NHS Foundation Trust J. Daglish, C. Robertson; Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, J. Bernatonlene, L. Hutchinson, University Hospitals Bristol NHS Foundation Trust, M. Gompel, L. Jennings; Leeds Teaching Hospitals NHS Trust, M. Dowie, S. O’Riordan; University Hospitals of Leicester NHS Trust, W. Ausalut, S. Bandi; North Manchester General Hospital, Pennine Acute Hospitals NHS Trust, P. McMaster, C. Murphy; Royal Liverpool and Broadgreen University Hospitals NHS Trust, M. Chaponda, S Paulus. Voluntary services (named alphabetically): Blue Sky Trust, C. Dufton, B. Oliver; Body and Soul, J. Marsh; Faith in People, I. Clowes; Positively UK, M. Kiwanuka; Positive Parenting & Children, B. Chipalo.

Disclosure statement

Marthe Le Prevost, Diane Melvin, Francesca Parrott, Caroline Foster, Deborah Ford, Michael Evangeli, Kate Sturgeon Diana M Gibb and Ali Judd have no potential conflicts of interest. Katie Rowson works part-time for the Childrens HIV Association (CHIVA). Alan Winston has received investigator initiated grants, speaker fees or honoraria from GSK, ViiV, BMS, Merck and Janssen. Alejandro Arenas-Pinto has received research grants from ViiV Healthcare, Janssen Cilag and Pfizer, not related to the submitted work.

Additional information

Funding

Monument Trust and PENTA Foundation. The MRC Clinical Trials Unit at UCL is supported by the Medical Research Council (programme number MC_UU_12023/26).