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2018 ; 5
(ä): e22
Nephropedia Template TP
gab.com Text
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English Wikipedia
Internalized HIV stigma, bullying, major depressive disorder, and high-risk
suicidality among HIV-positive adolescents in rural Uganda
#MMPMID29997894
Ashaba S
; Cooper-Vince C
; Maling S
; Rukundo GZ
; Akena D
; Tsai AC
Glob Ment Health (Camb)
2018[]; 5
(ä): e22
PMID29997894
show ga
BACKGROUND: Studies conducted in sub-Saharan Africa suggest a high prevalence of
depression and suicidality among adolescents living with HIV (ALWH). This is an
important public health issue because depression is known to compromise HIV
treatment adherence. However, the drivers of depression and suicidality in this
population are unclear. We conducted a cross-sectional study to estimate the
associations between internalized stigma, bullying, major depressive disorder,
and suicidality. METHODS: We conducted a cross-sectional survey between November
2016 and March 2017, enrolling a consecutive sample of 224 ALWH aged 13-17 years.
We collected information on demographic characteristics, internalized HIV-related
stigma (using the six-item Internalized AIDS-Related Stigma Scale), bullying
victimization (using the nine-item Social and Health Assessment Peer
Victimization Scale), major depressive disorder [using the Mini International
Neuropsychiatric Interview for Children and Adolescents (MINI-KID)], and
suicidality (also using the MINI-KID). We fitted multivariable logistic
regression models to estimate the associations between stigma, bullying, major
depressive disorder, and suicidality. RESULTS: Thirty-seven participants (16%)
had major depressive disorder, 30 (13%) had suicidality, and nine (4%) had
high-risk suicidality. Ninety-one participants (41%) had high levels of
internalized stigma, while 97 (43%) reported two or more bullying events in the
past year. In multivariable logistic regression models, major depressive disorder
had a statistically significant association with bullying (AOR = 1.09; 95% CI
1.00-1.20; p = 0.04); while suicidality (low, moderate, high risk) had
statistically significant associations with both bullying (AOR = 1.09; 95% CI
1.01-1.17; p = 0.02) and stigma (AOR = 1.30; 95% CI 1.03-1.30; p = 0.02).
CONCLUSIONS: Among ALWH in rural Uganda, stigma and bullying are strongly
associated with major depressive disorder and suicidality. There is a need to
incorporate psychological interventions in the mainstream HIV care to address
these challenges for optimal management of HIV among ALWH.