Prevalence and Factors Associated with Mental Health Challenges Among Adolescents with HIV and Viral Non-Suppression in Rural Northern Uganda

Kwesiga Jeremiah Mutinye¹Justine Diana Namuli²Benedict Akimana³Joyce Nalugya²Sabrina Bakeera-Kitaka²Seggane Musisi²Pontiano Kaleebu⁴Moffat Nyirenda⁴Etheldreda Nakimuli-Mpungu^4*

• ¹Medical Research Council, Uganda Virus Institute, London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
• ²Makerere University College of Health Sciences, Kampala, Uganda
• ³Ministry of Health, Butabika National Referral Hospital, Kampala, Uganda
• ⁴London School of Hygiene and Tropical Medicine, University of London, London, London, United Kingdom

Introduction: Adolescents living with HIV(ALWH) face significant mental health challenges, such as depression and anxiety, which negatively impact their HIV treatment outcomes. This study investigated the prevalence and factors associated with mental health challenges among adolescents with unsuppressed viral loads in Northern Uganda.Methods: In 2021, 121 dyads of caregivers and ALWH (10 to 18 years) with unsuppressed viral loads were recruited from five community-based HIV clinics in Kitgum district. They were assessed for mental health challenges using the Revised Child Anxiety and Depression Scale (RCADS-25), the Patterson Suicide Risk Assessment Tool and the Clinician-administered Post-traumatic Stress Disorder Scale for Children and Adolescents (CAPS-CA). Bivariate and multivariate analysis of the data was carried out using STATA version 18.Results: Of the 121 participants, 75 (61.97%) had either depression or anxiety or both. Depression was present in 45.45% of individuals, and all participants with depression also had comorbid anxiety. Notably, 16.52% of participants experienced anxiety without comorbid depression. Factors independently associated with mental health challenges included food insecurity (p = 0.003; OR = 0.03), post-traumatic stress disorder (PTSD) (p < 0.0001; OR = 1.33), and high transportation costs to health facilities (p = 0.0069; OR = 1.00). However, no significant association was observed between mental health challenges and gender (p = 0.94; χ² = 0.009). Conclusion: These results emphasize the importance of addressing underlying socio-economic and psychological factors to improve mental health well-being. Targeted interventions focused on reducing barriers to resources and providing mental health support are essential for fostering equitable mental health outcomes.