Suicide behaviour among adolescents in a high HIV prevalence region of western Kenya: A mixed-methods study

Suicidal Ideation Among Kenyan Youth: A Qualitative Analysis of Online Life Stories

This study examines the experiences of suicidal ideation among Kenyan youth through a qualitative analysis of online narratives, a sample that comprised 15 young individuals aged 17-26 who shared their stories on online platforms. Employing Interpretative Phenomenological Analysis (IPA), the study highlights complex interactions of societal pressures, mental health challenges, and identity struggles that contribute to suicidal ideation. Key themes identified include the impact of cultural expectations, mental health stigma, isolation, and identity crises. By prioritizing the personal voices of the youth, the study sheds light on the deeply contextual nature of suicidal ideation and offers insights into the meanings individuals ascribe to their experiences. The findings advocate for culturally sensitive interventions and underscore the need to address mental health stigma, aiming to foster a supportive societal environment for Kenyan youth grappling with these issues.

Mental Health Problems Across the HIV Care Continuum for Adolescents Living with HIV in Sub-Saharan Africa: A Scoping Review

Mental health problems (e.g., anxiety, depression) are frequently experienced by adolescents living with HIV (ALWH) and can worsen HIV-related outcomes. This scoping review synthesizes the existing research on ALWHs' mental health problems at multiple steps along the HIV care continuum in sub-Saharan Africa. Searching PubMed, CINAHL, EMBASE, and PsycINFO identified 34 peer-reviewed studies that met inclusion criteria. Most studies assessed ALWHs' mental health problems at the "Engaged or Retained in Care" continuum step, are cross-sectional, focus on depression and anxiety, and used measures developed in high-income countries. Studies identify mental health problems among ALWH as prevalent and barriers to care. Significant gaps remain in understanding how mental health problems and their relationships with HIV-related health outcomes shift across the continuum. Additional attention is needed, especially at the HIV testing and viral suppression steps, to generate a more comprehensive understanding of mental health needs and priority timepoints for intervention for ALWH.

Factors associated with the risk of suicidal behavior among adolescents transitioning to secondary school in Nairobi County, Kenya: a cross-sectional study

Introduction

adolescence is a transitory stage in the lives of young people. The transition from primary to secondary school among adolescents is associated with suicidal behavior but is not well characterized in the Kenyan context. This study sought to elucidate factors associated with the risk of suicidal behavior among adolescents aged 11-18 years in transition to secondary school.

Methods

a cross-sectional design was employed in the study that was conducted among adolescents in 5 randomly selected secondary schools in Nairobi County. The study involved 539 students who had joined form 1 in January 2020. Data were collected using the suicide behavior questionnaire-revised (SBQ-R) in March 2020. Factors associated with suicidal behavior were assessed using a generalized linear model (GLM), using a poisson distribution with a log-link function to estimate adjusted prevalence ratios (aPR), and a significance level of p=.05.

Results

one-fifth (20.04%) of adolescents with a median age of 14 years were at risk of suicidal behavior. Depression (aPR=3.16, C.I {1.85, 5.41}, p=0.001) and lifetime alcohol use (aPR=1.87, C.I {1.17, 2.97}, p=0.009) were found to be significant factors for suicidal behavior.

Conclusion

depression and lifetime alcohol use are associated with the risk of suicidal behavior among adolescents transitioning from primary to secondary school. Interventions may need to be targeted at the pre-secondary or primary school level to prevent underage alcohol use and enhancement of social support to prevent depression in this demographic of the population.

The prevalence of mental health problems in sub-Saharan adolescents: A systematic review

Background and purpose

Most research regarding child and adolescent mental health prevention and promotion in low-and middle-income countries is undertaken in high-income countries. This systematic review set out to synthesise findings from epidemiological studies, published between 2008 and 2020, documenting the prevalence of mental health problems in adolescents from across sub-Saharan Africa.

Methods

A systematic search of multiple databases (MEDLINE, PsycINFO, Scopus) and Google Scholar was conducted guided by the Joanna Briggs Institute (JBI) Reviewer’s manual for systematic reviews of observational epidemiological studies. Studies included reported prevalence outcomes for adolescents aged 10–19 using either clinical interviews or standardized questionnaires to assess psychopathology. Clinical samples were excluded.

Results

The search yielded 1 549 records of which 316 studies were assessed for eligibility and 51 met the inclusion criteria. We present a qualitative synthesis of 37 of these 51 included articles. The other 14 studies reporting prevalence rates for adolescents living with HIV are published elsewhere. The prevalence of depression, anxiety disorders, emotional and behavioural difficulties, posttraumatic stress and suicidal behaviour in the general adolescent population and selected at-risk groups in 16 sub-Saharan countries (with a total population of 97 616 adolescents) are reported.

The Prevalence of Suicidal Ideation and Attempt Among Young People with HIV/AIDS: a Systematic Review and Meta-Analysis

Studies have suggested that suicidal ideation and attempt are highly prevalent among young people with HIV/AIDS and have been linked with increased risk of complete suicide. However, thus far, there are no worldwide systematic reviews and meta-analysis of the prevalence of suicidal ideation and attempt among young people with HIV/AIDS. A systematic search of PubMed, Scopus, and Web was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Prevalence rates from individual studies were pooled by using a random-effect meta-analysis. The quality of included studies was assessed by the Joanna Briggs Institute's quality assessment checklist. We used the Cochran's Q and the I² tests to measure heterogeneity across the studies. In total, 14 studies involving 4842 young people with HIV/AIDS were included in this meta-analysis. Our random effect meta-analysis indicated that roughly a quarter of young people with HIV/AIDS had lifetime suicidal ideations [24.38% (95% CI; 18.49-31.44)], and more than one in ten had current [10.33% (95% CI; 6.13-16.88)], and 6 month [13.03% (95% CI; 4.71-31.24)] suicidal ideations. Likewise, a significant proportion of young people with HIV/AIDS had current [3.75% (95% CI; 2.30-6.06)], 6 month [15.33% (95% CI; 10.00-22.78)], and lifetime [13.05% (95% CI; 7.55-21.61)] suicidal attempts. The pooled prevalence estimate of both suicidal ideation and attempts varied according to the sample size of the participants. This study found that a considerable proportion of young people with HIV/AIDS had suicidal ideation and attempt, suggesting the urgent needs of intervention strategies to relieve the suffering and possibly prevent death due to suicide.