Anxiety and depression symptoms in young people with perinatally acquired HIV and HIV affected young people in England

Abstract

Adolescents with perinatal HIV (PHIV) may be at higher risk of anxiety and depression than HIV negative young people. We investigated prevalence of anxiety and depression symptoms in 283 PHIV and 96 HIV-affected (HIV-negative) young people in England recruited into the Adolescents and Adults Living with Perinatal HIV (AALPHI) cohort. We used Hospital Anxiety and Depression Scale (HADS) scores and linear regression investigated predictors of higher (worse) scores.115 (41%) and 29 (30%) PHIV and HIV-affected young people were male, median age was 16 [interquartile range 15,18] and 16 [14,18] years and 241 (85%) and 71 (74%) were black African, respectively. There were no differences in anxiety and depression scores between PHIV and HIV-affected participants. Predictors of higher anxiety scores were a higher number of carers in childhood, speaking a language other than English at home, lower self-esteem, ever thinking life was not worth living and lower social functioning. Predictors of higher depression scores were male sex, death of one/both parents, school exclusion, lower self-esteem and lower social functioning. In conclusion, HIV status was not associated with anxiety or depression scores, but findings highlight the need to identify and support young people at higher risk of anxiety and depression.

Anxiety symptoms and felt stigma among young people living with perinatally or behaviourally-acquired HIV in Ukraine: A cross-sectional survey

“…However, studies of PHIV and HIV exposed/affected youth have found broadly similar results to our survey. A recent UK study of PHIV and HIV-affected negative young people, mostly black African with median age 16 years, found a prevalence of moderate/severe anxiety symptoms using HADS of around 15–18% in both groups [10]. Meanwhile in the USA, emotional problems were reported by 17% of HIV-exposed and 12% of PHIV youth in one study [9] while another found a 25% prevalence of any mood disorder among 197 PHIV youth [37].…”

“…Self- or anticipated stigma may be a barrier to disclosure of HIV status to others and to seeking emotional and practical support, and this may become more relevant for the PHIV group as they move away from family in the coming years and navigate disclosure to new friends and partners [43]. The association between lower self-esteem and poorer mental health has been found among PHIV young people elsewhere [10, 44] and in general population samples [45], and is a potential area for intervention; however, even after adjusting for self-esteem, felt stigma remained associated with recent moderate/severe anxiety in our study.…”

“…Young people were also asked: “ Have you or a loved one ever thought that you had low mood (depression) , fears and worries (anxiety) , aggression or anger , or any other emotional health issues ?” and about history of referral to or attendance at a service for an emotional health issue (questions from a UK study of young people with or affected by HIV [10]).…”

Self-harm in young people with perinatal HIV and HIV negative young people in England: cross sectional analysis

“…However, if this were the case one would expect higher prevalence of self-harm or depression in the HIV negative comparison group. The AALPHI comparator group did in fact have higher prevalence of self-harm (19.0% vs. 12.2%) however the difference was not statistically significant ( p = 0.089), and there was no difference in the level of depression between the two groups in a previous analysis [39].…”

“…Another possibility is that our study did not detect an effect of depression due to its relationship with self-esteem, which itself was a strong predictor of self-harm. Low self-esteem has been found to both increase an individual’s vulnerability to depression, and to be a symptom of depression [17], and we recently found that lower self-esteem predicted higher depression scores in the AALPHI cohort [39]. Previous research has shown that low self-esteem and depressive symptoms often co-occur among the general population of adolescents [40, 41], although some studies suggest that the direction of the association between self-esteem and depressive symptoms is predominantly from self-esteem to depressive symptoms [42, 43].…”