Abstract
Young people living with HIV (YPLHIV) in sub-Saharan Africa (SSA) are at high risk of having a poor quality of life. Addressing wellbeing explicitly within HIV/AIDS policies could assist mitigation efforts. However, guidance on wellbeing measures to evaluate policies for YPLHIV is scarce. The aims of this mixed-methods review were to identify: i) key dimensions of wellbeing and ii) wellbeing measures that align to these dimensions among YPLHIV (15–24 years) in SSA. We searched six social science and medical databases, including grey literature. We included studies that examined correlates and lived experiences of wellbeing, among YPLHIV in SSA, from January 2000 to May 2019. Two reviewers independently screened abstracts and full texts and assessed methodological quality of included articles. We analysed quantitative and qualitative data using descriptive and meta-ethnographic approaches, respectively. Thereafter, we integrated findings using a framework approach. We identified 6527 citations. Of these, 10 quantitative and 30 qualitative studies were included. Being male, higher educational status, less stigma and more social support were likely correlates of wellbeing. Themes that shaped experiences suggestive of wellbeing were: 1) acceptance and belonging— stigma, social support; 2) coping; 3) standard of living. Our final synthesis found that the following dimensions potentially characterise wellbeing: self-acceptance, belonging, autonomy; positive relations, environmental mastery, purpose in life. Wellbeing for YPLHIV is multi-dimensional and relational. Relevant measures include the Personal Wellbeing Index, Ryff’s Psychological Wellbeing Scale and Mental Health Continuum Short Form. However, psychometric evaluations of these scales among YPLHIV in SSA are needed.
Highlights
Adolescence and young adulthood are critical periods for wellbeing, an indicator of the quality of life
For the qualitative review, data saturation among 20–24-year-olds and young people living with HIV (YPLHIV) in rural settings was not reached, leaving gaps in our understanding of how these factors may have shaped wellbeing. The aim of this mixed-methods review was to identify dimensions of wellbeing among YPLHIV and measures that align to these dimensions for application in Human immunodeficiency virus (HIV) policy evaluations
This review has shown that social support was a key correlate of poor mental health and that social relationships shaped positive lived experiences
Summary
Adolescence and young adulthood are critical periods for wellbeing, an indicator of the quality of life. This life stage is important for building human and social capital, resources that can sustain wellbeing in adulthood [1–3]. For young people living with HIV (YPLHIV), who because of greater access to anti-retroviral therapy (ART), can expect to reach adulthood, building and sustaining wellbeing as they grow older is crucial. Models predict that investment in the quality of life among the growing youth population in SSA, via addressing health needs, could increase labour productivity and resultantly accelerate economic growth [11]. If long-run economic growth is to be achieved, public health policies need to promote the wellbeing among YPLHIV, a vulnerable and growing population in this region
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