Psychiatric Disorders in Adolescents Living with HIV and Association with Antiretroviral Therapy Adherence in Sub-Saharan Africa: A Systematic Review and Meta-analysis

Olashore, Anthony A.; Paruk, Saeeda; Akanni, Oluyemi O.; Tomita, Andrew; Chiliza, Bonginkosi

doi:10.1007/s10461-020-03100-z

Cited by 17 publications

(33 citation statements)

References 72 publications

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“…To the best of our knowledge, this is the first review from SSA to comprehensively collate information about factors associated with CMDs in YLWH. Recent reviews from SSA involving YLWH provide an overview of some of these factors because of broadly covering multiple psychiatric disorders [13,14], focussing on only one correlate – ART adherence [14] or including HIV‐positive young people up to 19 years only [13,14]. In this review, 19 studies reported the correlates of either major depression [64], symptoms of major depression [65] or depressive symptoms among YLWH [28,48,49,53,54,56,58,61,62,66,67,69,77,78,81,82,84].…”

Section: Resultsmentioning

confidence: 99%

“…[14] only addresses the association of these disorders with ART adherence. In both reviews [13,14], their approach limits the possibility to understand which contextual factors importantly relate to CMDs, the most frequent of the psychiatric disorders. This review addresses this gap.…”

Section: Introductionmentioning

confidence: 99%

“…Among young people living with HIV (YLWH), global reviews [5,11,12] report the prevalence of comorbid CMDs as high as 44.0% for depressive disorders and 48.2% for anxiety disorders. In recent reviews on the burden of psychiatric disorders among YLWH aged 10 to 19 years in SSA [13,14], depressive and anxiety symptoms ranged from 14% to 53% and 15% to 25% respectively. The burden of CMDs may also be higher in YLWH than their peers without HIV [15] or even other vulnerable groups of young people, such as those in juvenile detention [16].…”

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confidence: 99%

“…Second, although the recent reviews from SSA give important information on the prevalence and range of mental disorders in YLWH, the review by Olashore et al [14] only addresses the association of these disorders with ART adherence. In both reviews [13,14], their approach limits the possibility to understand which contextual factors importantly relate to CMDs, the most frequent of the psychiatric disorders. This review addresses this gap.…”

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confidence: 99%

“…Past systematic reviews on the burden of CMDs among people living with HIV from SSA [9,38,42] have only considered studies recruiting adults living with HIV sidelining YLWH who currently represent a considerable percentage of people living with HIV. The recent systematic reviews involving YLWH from SSA [13,14] are limited to young people aged 10 to 19 years only and broadly focus on many psychiatric disorders. For the current systematic review, the overall objective was to summarize the available evidence on the prevalence and factors associated with CMDs among YLWH aged 10 to 24 years from SSA.…”

mentioning

confidence: 99%

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Prevalence and factors associated with common mental disorders in young people living with HIV in sub‐Saharan Africa: a systematic review

et al. 2021

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Introduction Common mental disorders (CMDs) particularly depression and anxiety, are highly comorbid with HIV also in young people living with HIV (YLWH). In sub‐Saharan Africa (SSA) where most YLWH reside, there are limited summary data on CMDs among these youths, yet there are previous systematic reviews summarizing data on CMDs among adults living with HIV. We conducted a systematic literature review on the prevalence and correlates of CMDs among YLWH, aged 10 to 24 years, from SSA. Methods We searched African Index Medicus, African Journals Online and five other electronic databases (from database inception up to 31 December 2020) for relevant studies published in English. The key search terms applied were as follows: “Depression OR Anxiety”, “Young people”, “HIV infections” and “sub‐Saharan Africa”. Results and discussion Out of 3989 articles, 31 studies were included in the review. The prevalence of CMDs in YLWH widely varied ranging between 16.0% and 40.8% for major depression, 4.4% and 52.6% for depressive symptoms and 2.2% and 25.0% for anxiety symptoms. Anxiety disorder was estimated at 45.6%. Four of the five included studies with a comparison group of HIV‐negative young people reported significantly higher prevalence estimates of depressive disorders among YLWH. Several sociodemographic, psychosocial and HIV‐related correlates of CMDs were reported but most lacked consensus across studies. Nevertheless, female sex, older age, fewer schooling years, HIV‐positive status, bullying, sexual abuse, HIV‐related stigma, social support and poor antiretroviral therapy adherence were frequently reported (in ≥2 studies) as significant correlates of depressive symptoms among YLWH. Higher social support was the only frequent significant correlate of anxiety symptoms. Conclusions The burden of CMDs among YLWH from SSA is substantial and appears to be significantly higher when compared with HIV‐negative peers, particularly for depressive disorders. However, more comparative research is needed. Importantly, screening for CMDs at the youth HIV‐clinics should be prioritized especially for YLWH at high risk of CMDs, to facilitate early management or referral for treatment. Furthermore, youth‐friendly psychological interventions addressing CMDs in YLWH should urgently be piloted in SSA, incorporating contextual components that may directly or indirectly reduce symptoms of CMDs among YLWH, such as social support.

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