Methods: Cross sectional data from a two-year pilot study (2020-2022) for adolescents living with HIV were analyzed. A total of 89 child-caregiver dyads (N=178) were recruited into the study Adolescents were eligible to participate if they were: 1) living with HIV and aware of their status; 2) between 10-14 years; 3) enrolled on antiretroviral therapy in participating clinics; and 4) living within a family, including with extended family. Multivariate regression analyses were conducted to determine the relationship between shame, as measured by the Shame Questionnaire and adolescents’ mental health functioning, assessed using the Child Depression Inventory, Beck Hopelessness Scale, UCLA Loneliness Scale, Childhood Post-Traumatic Stress Reaction Index, and Tennessee Self-Concept Scale.
Results: The average age was 12.2 years, and 56% of participants were female. HIV-related shame was associated with high levels of depressive symptoms (b=0.63, 95% CI=0.41, 0.86, p<.001), hopelessness (b=0.35, 95% CI =0.12, 0.57, p=0.003), PTSD symptoms (b=3.10, 95% CI =1.63, 4.58, p<.001), loneliness (b=1.02, 95% CI=0.22, 1.82, p=0.013), and low levels of self-concept (b=-1.13, 95% CI = -1.93, -0.32, p =0.007). In addition, gender (being a female child) was associated with high levels of depressive symptoms (b=0.71, 95% CI = 0.37, 0.62, p=0.013), hopelessness (b= 1.90, 95% CI =0.57, 3.24, p=0.006), PTSD symptoms (b=10.50, 95% CI =1.81, 19.18, p=0.018), and low self-concept (b=-8.06, 95% CI =-12.82, -3.31, p=0.001).
Implication and Conclusion: Study findings contribute to the limited literature examining HIV-related shame and the mental health of young people living with HIV in SSA. Findings support the need for the development of strategies to help adolescents overcome the shame of living with HIV and mitigate the effects of shame on adolescents’ mental health and treatment outcomes.