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What you need to know about depression in Adolescents Living with HIV

World Health Day 7 April 2017

About Depression:

Depression is a mental health illness that affects an individual’s self-worth. It is a serious problem that impacts on the individual’s ability to function, perform everyday tasks and his/her interpersonal relationships. When left untreated, depression can lead to self-harm, and at worst suicide.

Depression in adolescents living with HIV

Depression can affect both adults and children. Although anyone can suffer from depression, young people living with HIV are at a higher risk of suffering from this illness. Evidence suggests that stigma and discrimination affect the psychosocial well-being of Adolescents living with HIV (ALHIV)[1]. In one study 23% of ALHIV reported suicidal ideation in the seven days preceding the survey[2]

Causes for Depression in HIV+ adolescents:

Depression is not an inevitable aspect of living with HIV, but is often triggered by stress, difficult life events, side effects of medications, or the effects of HIV on the brain. The prevalence of depression may increase with the severity of symptoms.

For ALHIV depression can be caused or magnified by stigma and discrimination; death in the family; not having a boy/girlfriend; dissatisfaction with physical appearance; fewer years of schooling or failing a school term; living in poverty; being bullied and not having disclosed or shared their HIV status with someone else.

One study in Malawi showed that having fewer years of schooling and being bullied for taking medications were most clearly associated with depression.[3] The stigma attached to HIV is also often a leading cause of ALHIV ending up with severe depression.

Effects of Depression in HIV+ adolescents:

Depression has a detrimental impact on treatment outcomes, the wellbeing and the development of HIV-infected youth. Studies have showed that depression affects adherence to ARV treatment, seen by the declines in CD4 count, drug resistance and discontinuation of treatment. Depressions can also accelerate the progression of HIV to AIDS and even death.[4]

How Depression can be prevented and treated:

The impact of depression on ALHIV can affect not only their development but also their opportunities later on in life. Detecting depression early and treating it goes a long way in improving the adherence to treatment and quality of life.

Prevention and treatment measures include youth friendly clinics, improving education, social protection for poverty alleviation, and reducing violence and abuse. Building psychosocial resilience ALHIV who may experience stigma and discrimination due to HIV is also critical to preventing depression.[5]