Prevalence, Risk Factors, and Negative Outcomes of Anxiety and Depressive Disorders among HIV-Infected Children and Adolescents in Uganda: CHAKA Study 2014-2017

Abstract

Background. Children and adolescents infected with HIV/AIDS (CA-HIV) experience a considerable burden of depressive and anxiety disorders that have a tendency to persist into adulthood. The aim of this study was to determine the prevalence of anxiety, depression, and their clinical correlates among children and adolescents with HIV/AIDS (CA-HIV) in Uganda. Methods. A random sample of 1339 CA-HIV (ages 5-18 years) and their caregivers completed a standardized DSM-5-referenced psychiatric rating scale, the Child and Adolescent Symptom Inventory-5 (CASI-5). The prevalence of “anxiety and depression” was estimated at 95% confidence intervals. Logistic and ordinal regression models were fitted for the clinical correlates and clinical outcomes. Results. The overall prevalence of “any anxiety and depressive disorders” was 13.7% at 95% CI (based upon the symptom count criteria); 4.0% (95% CI) met the clinical psychiatric disorder criteria (both symptom count and functional impairment criteria). Anxiety disorder was more prevalent (9%, 95% CI) than depression (6.4%, 95% CI). Correlates of “anxiety and depressive disorders” included age of the child, caregiver’ psychological distress, caregivers’ age, child-caregiver relationship, and child’s current CD4 count (aOR1.00, 95% CI 1.02–1.05; p = 0.021 ). Anxiety disorders (aOR 2.58, 95% CI 1.16-5.42; p = 0.02 ) and depressive disorders (aOR 2.47, 95% CI 1.93–6.52; p = 0.041 ) were also associated with hospital admissions. Limitations. Analyses were cross-sectional; we cannot comment on the causal directions. The results are entirely based upon caregiver’ reports. Conclusions. There is an urgent need to integrate mental health services into routine HIV care for CA-HIV in sub-Saharan Africa.

The impact of COVID-19 changes and disruptions on generalized anxiety disorder among young adults living with HIV (YLHIV) in Uganda

“…Recent studies have highlighted the prevalence and significance of anxiety disorders among adolescents living with HIV. For instance, a study in Uganda found that the prevalence of anxiety disorders in this group was 9%, compared to 6.4% for depression (Mpango et al, 2022). Unlike depression, anxiety has also been found to have a stronger association with HIV-related stigma, a key factor in the lives of YALHIV (Zhang et al, 2023).…”