Relationships with caregivers and mental health outcomes among adolescents living with HIV: A prospective cohort study in South Africa

Background Mental health problems may impact adherence to anti-retroviral treatment, retention in care, and consequently the survival of adolescents living with HIV. The adolescent-caregiver relationship is an important potential source of resilience. However, there is a lack of longitudinal researc...

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Bibliographic Details
Published in:BMC Public Health 2020
Main Authors: Shenderovich, Yulia, Boyes, Mark, Michelle Degli Esposti, Casale, Marisa, Toska, Elona, Roberts, Kathryn J, Cluver, Lucie
Format: Text Resource
Language:English
Subjects:
Adolescents
Anxiety
Caregivers
Communication
Data collection
HIV
Human immunodeficiency virus
Mental depression
Mental health
Supervision
Teenagers
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Summary:Background Mental health problems may impact adherence to anti-retroviral treatment, retention in care, and consequently the survival of adolescents living with HIV. The adolescent-caregiver relationship is an important potential source of resilience. However, there is a lack of longitudinal research in sub-Saharan Africa on which aspects of adolescent-caregiver relationships can promote mental health among adolescents living with HIV. We draw on a prospective longitudinal cohort study undertaken in South Africa to address this question. Methods The study traced adolescents aged 10-19 initiated on antiretroviral treatment in government health facilities ( n = 53) within a health district of the Eastern Cape province. The adolescents completed standardised questionnaires during three data collection waves between 2014 and 2018. We used within-between multilevel regressions to examine the links between three aspects of adolescent-caregiver relationships (caregiver supervision, positive caregiving, and adolescent-caregiver communication) and adolescent mental health (depression symptoms and anxiety symptoms), controlling for potential confounders (age, sex, rural/urban residence, mode of infection, household resources), n =926 adolescents. Results Improvements in caregiver supervision were associated with reductions in anxiety (0.98, 95% CI 0.97-0.99, p=0.0002) but not depression symptoms (0.99, 95% CI 0.98-1.00, p=.151), while changes in positive caregiving were not associated with changes in mental health symptoms reported by adolescents. Improvements in adolescent-caregiver communication over time were associated with reductions in both depression (IRR=0.94, 95% CI 0.92-0.97, p
DOI:10.21203/rs.3.rs-62974/v2