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Social and Economic Equity and Family Cohesion as Potential Protective Factors from Depression Among Adolescents Living with HIV in Uganda

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Abstract

Adolescents living with HIV in Uganda are impacted by poverty and face a number of health and social challenges including access to medication, health complications, and social stigma. These stressors have been linked to depression, which can lead to lower HIV treatment adherence. This study seeks to determine how social and economic equity, family cohesion, and social supports may be related to depression among adolescents living with HIV. We used baseline data from the Suubi + Adherence study, a 5-year longitudinal randomized controlled trial among adolescents living with HIV in southwestern Uganda (n = 675; ages 10–16 years). Hierarchical logistic regression models were conducted separately among in-school adolescents and out-of-school adolescents to assess the hypothesized associations between economic and social equity, social support, and depression. About half of the participants meet the criteria for depression. Adolescents with depression were found to have fewer economic and social supports. Our findings indicate that social and economic equity [odds ratio (OR) = 0.85, 95% confidence interval (CI) 0.74, 0.99], family cohesion (OR = 0.94, 95% CI 0.91–0.96), and social support from friends (OR = 0.95, 95% CI 0.91–0.998) are associated with depression for in-school HIV infected adolescents and could be protective factors. The results of this study suggest that social and economic equity may play a protective role against depression and other poor mental health outcomes. Potential interventions for adolescents living with HIV should consider these social and familial factors as they may be protective of depression in this population.

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Acknowledgements

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) and the National Institutes of Health (NIH), Grant #K02 DA043657 (PI: Patricia Cavazos-Rehg). 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.

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Cavazos-Rehg, P., Xu, C., Kasson, E. et al. Social and Economic Equity and Family Cohesion as Potential Protective Factors from Depression Among Adolescents Living with HIV in Uganda. AIDS Behav 24, 2546–2554 (2020). https://doi.org/10.1007/s10461-020-02812-6

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