Preventing mental health conditions in adolescents living with HIV: an urgent need for evidence.

Christina A Laurenzi,Mark Tomlinson,G J Melendez‐Torres,David A Ross,Chiara Servili,Tarun Dua,Amanda Brand,Sarah Skeen,Olamide Akin‐Olugbade,Melissa Bradshaw,Nina Abrahams,Sarah Gordon,Stefani Du Toit

doi:10.1002/jia2.25556

Abstract

IntroductionAs adolescents transition from childhood to adulthood, they experience major physical, social and psychological changes, and are at heightened risk for developing mental health conditions and engaging in health‐related risk behaviours. For adolescents living with HIV (ALHIV), these risks may be even more pronounced. Research shows that this population may face additional mental health challenges related to the biological impact of the disease and its treatment, the psychosocial burdens of living with HIV and HIV‐related social and environmental stressors.DiscussionPsychosocial interventions delivered to adolescents can promote positive mental health, prevent mental health problems and strengthen young people’s capacity to navigate challenges and protect themselves from risk. It is likely that these interventions can also benefit at‐risk populations, such as ALHIV, yet there is little research on this. There is an urgent need for more research evaluating the effects of interventions designed to improve the mental health of ALHIV. We highlight four priorities moving forward. These include: generating more evidence about preventive mental health interventions for ALHIV; including mental health outcomes in research on psychosocial interventions for ALHIV; conducting intervention research that is sensitive to differences among ALHIV populations and involving adolescents in intervention design and testing.ConclusionsMore robust research on promotive and preventive mental health interventions is needed for ALHIV. Programmes should be informed by adolescent priorities and preferences and responsive to the specific needs of these groups.

Highlights

As adolescents transition from childhood to adulthood, they experience major physical, social and psychological changes, and are at heightened risk for developing mental health conditions and engaging in health-related risk behaviours
Our meta-analysis found that psychosocial interventions that included specific components were associated with more successful programme outcomes for adolescent mental health [24]
We argue that there should be an robust approach to generating evidence about how best to promote positive mental health, and prevent mental conditions and risk behaviours, in this population

Summary

| INTRODUCTION

As adolescents transition from childhood to adulthood, they undergo major physical, social and psychological changes [1]. Physical changes, which include puberty and rapid brain development, take place in the context of newly developing autonomy, responsibility and decision-making abilities This transition is influenced by a complex set of socio-economic factors, including family and cultural environments, which interact with each other and shape adolescents’ health trajectories and vulnerabilities [2]. Depression, anxiety, hopelessness and fear for the future are common in this population, which makes mental health a vital area of concern for ALHIV [9] Research shows that these risks are manifold, related to the biological impact of the disease and its treatment, the psychosocial burden of living with HIV and HIV-related social and environmental stressors. The same mechanisms that can contribute to poor health in adults living with HIV are likely to affect ALHIV; improving mental health can foster better HIV outcomes such as adherence and retention in care [22], especially for adolescents [23]

Findings

| DISCUSSION

| CONCLUSIONS