Community beliefs, HIV stigma, and depression among adolescents living with HIV in rural Uganda

Dados Bibliográficos

ID15456741
AutoresScholastic Ashaba (0000-0002-5822-2488, Mbarara University of Science and Technology, autor correspondente), Christine E Cooper-Vince (0000-0002-5043-6342, Massachusetts General Hospital), Dagmar Vořechovská (0000-0003-1495-0990, Massachusetts General Hospital), Godfrey Zari Rukundo (0000-0002-3739-1426, Mbarara University of Science and Technology), Samuel Maling (0000-0003-3320-5961, Mbarara University of Science and Technology), Dickens Akena (0000-0002-8886-4553, Makerere University), Alexander C Tsai (0000-0001-6397-7917, Harvard University)
Ano2019
Volume18
Fascículo3
Páginas169-180
Data de publicação2019-07-24
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoAfrican Journal of AIDS Research (JOURNAL)
Identificadores do periódicoISSN: 1608-5906 • E-ISSN: 1727-9445
EditoraTaylor & Francis (PUBLISHER • GB)
DOI10.2989/16085906.2019.1637912
PMID31339461
OpenAlexW2963626362
IdiomaEN
Citações recebidas28
Referências citadas89

The availability of and increased access to antiretroviral therapy (ART) has significantly reduced the morbidity and mortality associated with HIV. As a result, perinatally infected youth are increasingly able to reach adolescence. There is limited information about the psychosocial challenges facing adolescents living with HIV (ALWH) in rural settings of sub-Saharan Africa. We sought to understand psychosocial challenges facing ALWH in rural Uganda and their effects on mental health and HIV treatment outcomes. We conducted 5 focus group discussions and 40 one-on-one in-depth interviews in Mbarara, Uganda with adolescents (aged 13-17 years) and adult women caregivers. All interviews were audio-recorded, transcribed directly into English, and coded using thematic analysis to identify themes related to psychosocial adversities and mental health. Adversities faced by adolescents included negative community perceptions (perceived aggression, presumed early mortality), HIV stigma (enacted and internalized), vulnerability factors (loss of parents, poverty), and health challenges (depression, ART non-adherence). In the conceptual model that emerged from the findings, negative community perceptions (about perceived aggression or presumed early mortality) predisposed ALWH to experience enactments and internalization of stigma that led to depression and ART non-adherence. The data also identified several protective factors, including counselling, family and religious support, and timely serostatus disclosure. Interventions to correct community misperceptions about HIV can potentially reduce stigma and thereby improve physical and mental health outcomes of ALWH

Family medicine · Focus group · Human immunodeficiency virus (HIV · Mental health · Poverty · Psychiatry · Psychological intervention · Psychosocial · Qualitative research · Serostatus · Social stigma · Stigma (botany · Thematic analysis · Viral load · Adolescent Sexual and Reproductive Health · Clinical Psychology · HIV/AIDS Research and Interventions · Medicine · Poverty, Education, and Child Welfare · Psychology