Depression and Incident HIV in Adolescent Girls and Young Women in HIV Prevention Trials Network 068: Targets for Prevention and Mediating Factors.

Journal: American journal of epidemiology

Volume: 189

Issue: 5

Year of Publication: 2020

Affiliated Institutions:  Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California. Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, Bristol University, Bristol, United Kingdom. Department of Psychology, University of California, Los Angeles, Los Angeles, California. Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California. HIV Prevention Trials Network Leadership and Operations Center, Science Facilitation Department, FHI , Durham, North Carolina. Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington. Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland. Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.

Abstract summary 

The human immunodeficiency virus (HIV) epidemic among adolescent girls and young women (AGYW) in sub-Saharan Africa is a critical public health problem. We assessed whether depressive symptoms in AGYW were longitudinally associated with incident HIV, and identified potential social and behavioral mediators. Data came from a randomized trial of a cash transfer conditional on school attendance among AGYW (ages 13-21 years) in rural Mpumalanga Province, South Africa, during 2011-2017. We estimated the relationship between depressive symptoms and cumulative HIV incidence using a linear probability model, and we assessed mediation using inverse odds ratio weighting. Inference was calculated using the nonparametric bootstrap. AGYW with depressive symptoms had higher cumulative incidence of HIV compared with those without (risk difference = 3.5, 95% confidence interval (CI): 0.1, 7.0). The strongest individual mediators of this association were parental monitoring and involvement (indirect effect = 1.6, 95% CI: 0.0, 3.3) and reporting a partner would hit her if she asked him to wear a condom (indirect effect = 1.5, 95% CI: -0.3, 3.3). All mediators jointly explained two-thirds (indirect effect = 2.4, 95% CI: 0.2, 4.5) of the association between depressive symptoms and HIV incidence. Interventions addressing mental health might reduce risk of acquiring HIV among AGYW.

Authors & Co-authors:  Goin Dana E DE Pearson Rebecca M RM Craske Michelle G MG Stein Alan A Pettifor Audrey A Lippman Sheri A SA Kahn Kathleen K Neilands Torsten B TB Hamilton Erica L EL Selin Amanda A MacPhail Catherine C Wagner Ryan G RG Gomez-Olive F Xavier FX Twine Rhian R Hughes James P JP Agyei Yaw Y Laeyendecker Oliver O Tollman Stephen S Ahern Jennifer J

Study Outcome 

Source Link: Visit source

Statistics
Citations :  UNICEF Children and AIDS: statistical update. https://data.unicef.org/wp-content/uploads/2017/11/HIVAIDS-Statistical-Update-2017.pdf. Accessed August 25, 2018.
Authors :  19
Identifiers
Doi : 10.1093/aje/kwz238
SSN : 1476-6256
Study Population
Women,Girls
Mesh Terms
Adolescent
Other Terms
HIV/AIDS;South Africa;adolescent health;depression
Study Design
Randomized Control Trial,Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
United States