# Prevalence and factors associated with mental health challenges among adolescents with HIV and viral non-suppression in rural northern Uganda

## TL;DR

This study examines mental health issues among HIV-positive adolescents in rural Uganda and finds that emotional problems are common and linked to factors like food insecurity and trauma.

## Contribution

The study identifies specific socio-economic and psychological factors associated with mental health challenges in adolescents with unsuppressed HIV.

## Key findings

- 61.97% of adolescents with unsuppressed HIV had emotional problems, including 45.45% with depression.
- Food security and absence of recurrent infections were protective against mental health challenges.
- Post-traumatic stress symptoms were strongly associated with mental health issues.

## Abstract

Adolescents living with HIV (ALWH) face significant mental health challenges, such as depression and anxiety, which negatively impact their HIV treatment outcomes. This study investigated the prevalence and factors associated with mental health challenges among adolescents with unsuppressed viral loads in Northern Uganda.

In 2021, 121 dyads of caregivers and ALWH (10 to 18 years) with unsuppressed viral loads were recruited from five community-based HIV clinics in Kitgum district. They were assessed for mental health challenges using the Revised Child Anxiety and Depression Scale (RCADS-25), the Patterson Suicide Risk Assessment Tool and the Clinician-administered Post-traumatic Stress Disorder Scale for Children and Adolescents (CAPS-CA). Bivariate and multivariate analysis of the data was carried out using STATA version 18.

Emotional problems were observed in 61.97% of participants. Among these, depression was present in 45.45% of individuals, and all participants diagnosed with depression also exhibited significant comorbid anxiety symptoms. Notably, 16.52% of participants experienced anxiety without comorbid depression. Having food security (OR = 0.03; p = 0.003), and the absence of recurrent infections (OR = 0.47; p = 0.023) were protective against mental health challenges. However, significant post-traumatic stress symptoms were independently associated with mental health challenges (OR = 1.33; p < 0.0001). No significant association was observed between emotional problems and gender (χ2 = 0.009; p = 0.94).

These results emphasize the importance of addressing underlying socio-economic and psychological factors to improve mental health well-being. Targeted interventions focused on reducing barriers to resources and providing mental health support are essential for fostering equitable mental health outcomes.