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Relationship Between Mental Health and HIV Transmission Knowledge and Prevention Attitudes Among Adolescents Living with HIV: Lessons from Suubi + Adherence Cluster Randomized Study in Southern Uganda

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Abstract

We assessed the effect of depression, hopelessness, and self-concept on HIV prevention attitudes and knowledge about infection, transmission and sexual risk behavior among adolescents living with HIV in Uganda. Utilizing longitudinal data from 635 adolescents living with HIV, multiple ordinary least square regression was used to evaluate associations between the three indicators of mental health functioning at baseline and HIV knowledge and prevention attitudes at 12-months follow-up. We found that depression (β = − 0.17; 95% CI − 0.31, − 0.04) and hopelessness (β = − 0.16; 95% CI − 0.28, − 0.04) scores at baseline were associated with a 0.17 and 0.16 average reduction in HIV prevention attitudes and HIV knowledge scores, respectively at 12-months follow-up. However, self-concept was not significantly associated with HIV knowledge or prevention attitudes. Adolescents living with HIV with greater levels of hopelessness are at increased risk of having limited HIV knowledge while those with greater symptoms of depression had less favorable HIV prevention attitudes.

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Acknowledgements

Suubi+Adherence study was funded by the Eunice Kennedy Shriver National Institutes of Child Health and Human Development (NICHD) (Grant #1R01HD074949–01, PI: Fred M. Ssewamala). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Authors and Affiliations

  1. International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO, 63130, USA

    William Byansi, Rachel Brathwaite, Proscovia Nabunya, Ozge Sensoy Bahar, Christopher Damulira, Flavia Namuwonge & Fred M. Ssewamala

  2. Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, 02215, USA

    Madison Calvert

  3. Brown School, Washington University in St. Louis, St. Louis, MO, 63130, USA

    Mary M. McKay

  4. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, Box 15, New York, NY, 10032, USA

    Claude A. Mellins

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  1. William Byansi
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Contributions

RB and WB conducted data analysis. MC, WB, and RB contributed to literature review. RB and WB drafted first draft of the manuscript. PN, and OSB contributions to revisions of the manuscript. CD, FN supervised study implementation in the field, CM and MMM are co-investigators on the study, and FMS, conceptualized, received funding for the study, and led and supervised all aspects of study implementation. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to William Byansi.

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The authors have no conflict of interest to declare that are relevant to the content of this article.

Ethical Approval and Informed Consent

Adolescents provided voluntary written assent and caregivers provided consent for the adolescent to participate in the study. The recruitment and interaction with human subjects and their health information were completed according to protocols reviewed and approved by Columbia University (Protocol AAAK3852), the Makerere University School of Public Health (Protocol 210) and the Uganda National Council for Science and Technology (Protocol SS 2969) Ethics and Institutional Review Boards.

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Byansi, W., Brathwaite, R., Calvert, M. et al. Relationship Between Mental Health and HIV Transmission Knowledge and Prevention Attitudes Among Adolescents Living with HIV: Lessons from Suubi + Adherence Cluster Randomized Study in Southern Uganda. AIDS Behav 25, 3721–3733 (2021). https://doi.org/10.1007/s10461-021-03243-7

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