The Association of Self-Disclosure, Social Support and Depression Among Young People Living with HIV/AIDS in Sub-Saharan Africa (YPLWHA)

Background: In Sub-Saharan Africa, six out seven new HIV/AIDS infections occur among adolescents between 15 to 19 years of age. Adolescent girls between the ages of 15 to 24 years are twice as likely to be living with HIV/AIDS than their male counterparts (UNAIDS, 2022). The HIV/AIDS burden among adolescents is also associated with mental health challenges such as depression, anxiety and conduct problems. The comorbid mental health conditions and HIV/AIDS are debilitating with implications for morbidity and mortality. However, social support buffers the effects of stress, and attempts to address stigma and social exclusion experienced by YLWHA. Our study investigated the association of self-disclosure, social support and depression among Young People Living With HIV/AIDS (YPLWHA) in Sub-Saharan Africa.

Method: Data was collected from a cross-sectional study design of 318 YLWHA between the ages of 15-24 year in a Sub-Saharan African context The following measures were used; Patient Health Questionnaire (PHQ-9) for assessing depression, the Multidimensional Scale of Perceived Social Support (MSPSS) for assessing social support and the self-disclosure variables that ranged from knowledge about partner`s HIV status to disclosing HIV status to a partner. Multinomial logistic regression models were used to investigate the relationship between the variables and to estimate the best predictor for depression among YLWHA.

Results: At a cut-off score of <10 for (no to mild depression), 10 – 19 for (moderate depression) and >19 for (moderately severe to severe depression), 63.8% were classified as having no or mild of depression, 25.2% corresponded to moderate depression and 11% had moderately severe or severe depression. 60% of respondents who disclosed their HIV status to at least some people in their household were more likely to have PHQ scores corresponding to mild depression, while the remaining 40% of the respondents were more likely to have scores corresponding to moderate and severe depression. For the social support variables, the model estimation results generally revealed that respondents that scored high on social support were less likely to report higher depressive symptoms and those that scored low on social support reported moderate to high depressive symptoms. At 0.05 level of significance, (MSPSS>50; p =.047).

Implications: The findings from our study shed light on the importance of early self-disclosure of HIV/AIDS and the role that social support plays in buffering depressive symptoms among YLWHA. Our study demonstrates a critical gap for adolescent mental health interventions for YLWHA in resource constrictive settings. Interventions addressing social support and mental health stigma for YLWHA have potential to empower young girls, promote mental health literacy, and increase mental health services accessibility. Additionally, promoting early disclosure has the capacity to improve HIV/AIDS adherence, enhance coping strategies, foster the uptake and utilization of mental health services in low resource settings in Sub-Saharan Africa and globally. Future studies could work towards testing the efficacy of social support interventions that are culturally appropriate and contextually specific to adolescent mental health needs.