Prevalence and factors associated with psychological distress among pregnant and non-pregnant youth living with HIV in rural Uganda: a comparative study

ABSTRACT

Youth living with HIV (YLHIV) are prone to psychological distress, which may have detrimental effects on health outcomes. Pregnant youth have poor access to HIV care increasing the risk of vertical transmission of HIV to their infants. Both HIV and pregnancy are independently associated with poor mental health among adolescents. The factors that predispose women to poor mental health may also increase their risk of contracting HIV. Despite their desire to have children YLHIV are at a high risk of psychological distress. However, factors associated with psychological distress among YLHIV in rural Uganda are not well explored. Therefore, the purpose of this study was to determine the prevalence of, and factors associated with psychological distress among pregnant and non-pregnant YLHIV in south western Uganda. We enrolled 224 YLHIV aged 15-24 years both pregnant and nonpregnant (ratio 1:1) between December 2018 and March 2019. We obtained information on psychological distress and factors hypothesized to affect mental health outcomes among people living with HIV including internalized HIV stigma, intimate partner violence, self-esteem and social support. Bivariate and multivariable logistic regression analysis were used to estimate factors independently associated with psychological distress. The prevalence of psychological distress was 48.2%% among pregnant YLHIV and 32.14% among non-pregnant YLHIV. Factors significantly associated with psychological distress among pregnant YLHIV were HIV stigma (AOR=4.61; 95% CI 1.63–13.84; P=0.004), physical abuse (AOR=4.97; 95% CI 1.41- 17.56; P= 0.013), and separation from partner (AOR =0.03; 95% CI 0.001-0.580; P=0.020).

Acknowledgments

We thank the participants who took their time to participate in this study, and we also acknowledge the contributions of our research assistants to data collection and logistical support during the study period.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approval and consent to participate

The study was approved by the research ethics committee of Mbarara University of Science and Technology (#19/09-18), and all participants provided written informed before they were enrolled in the study.

Availability of data and materials

All data generated and analyzed during this study are included in this manuscript.

Authors’ contributions

CK and SA designed the research, were involved in data collection, carried out data analysis and wrote the manuscript. SM provided guidance in the study design, data analysis and edited the manuscript. ENM provided guidance in data analysis, interpretation of the study findings and edited the manuscript. MMK and AB provided support in the data collection, data analysis and edited the manuscript. All authors read and approved the final manuscript.

Additional information

Funding

The study was funded by the U.S. National Institutes of Health (Fogarty International Center (FIC), National Institute of Mental Health (NIMH) and National Institute of Neurological Disorders, and Stroke (NINDS)) under grant number D43TW010128.