The impact of discomfort with HIV status and hopelessness on depressive symptoms among adolescents living with HIV in Uganda

ABSTRACT

Introduction: Discomfort with and reluctance to disclose HIV status can lead to depression, social isolation, and poor medication adherence; we examined relationships among these variables within a sample of adolescents living with HIV in Uganda. Methods: We used baseline data from the Suubi + Adherence study, which recruited a total of 702 adolescents (ages 10–16 years) living with HIV in southwestern Uganda. Structural equation models were conducted separately among in-school adolescents and out-of-school adolescents to assess associations between discomfort level with HIV status and depressive symptoms and if this association was mediated by hopelessness. Results: Out-of-school adolescents had significantly higher depression scores compared with those in-school youth (M = 6.24 vs. M = 5.03, p < 0.001). Although high discomfort level with HIV status was significantly associated with higher depression scores among both in-school adolescents and out-of-school adolescents, this association among out-of-school adolescents (B = 0.49, 95%CI: 0.19, 0.79), was more substantial than for in-school adolescents (B = 0.10, 95%CI: 0.03, 0.17). Discussion: One’s discomfort with their HIV status and the extent to which they are hopeful about the future can contribute to the development of depressive symptoms and these factors need to be considered in the development of assessments and interventions for the treatment of depression among adolescents living with HIV.

KEYWORDS:

• Depression
• hopelessness
• HIV
• HIV status
• adolescents
• stigma

Disclosure statement

JB is a member of the board of directors and treasurer of MySafeRx Inc., a non-profit scientific research organization. He receives no financial compensation from this organization.

Additional information

Funding

Financial support for the Suubi + Adherence Study was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Grant # R01HD074949 (PI: Fred M Ssewamala), National Institutes of Health (NIH), Grant #K02 DA043657 (PI: Patricia Cavazos-Rehg) and the National Institutes on Alcohol Abuse and Alcoholism (NIAAA), Grant # F32AA027941 (PI: Jacob Borodovsky). The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Child Health and Human Development or the National Institutes of Health. We are grateful to the staff and the volunteer team at the International Center for Child Health and Development in Uganda for monitoring the study implementation process. Our special thanks go to all the children and their caregiving families who agreed to participate in the study.