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Ndongo FA, Kana R, Nono MT, Noah JPYA, Ndzie P, Tejiokem MC, Biheng EH, Ndie J, Nkoa TA, Ketchaji A, Ngako JN, Penda CI, Bissek ACZK, Ndombo POK, Hawa HM, Msellati P, Lallemant M, Faye A. Association between mental disorders with detectable viral load and poor adherence to antiretroviral therapy among adolescents infected with Human Immunodeficiency Virus on follow-up at Chantal Biya Foundation, Cameroon. J Epidemiol Popul Health 2024; 72:202193. [PMID: 38523399 DOI: 10.1016/j.jeph.2024.202193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 03/26/2024]
Abstract
INTRODUCTION Perinatally HIV-Infected Adolescents (HIVIA) are more likely to have mental health problems than their uninfected peers. In resource-limited settings, mental health disorders are rarely taken into account in the care offered to HIVIA and have an impact on their routine follow-up. The objective of this study was to assess the baseline socio-demographic factors and mental health conditions associated with detectable viral load or poor ART adherence in HIVIA on ART followed at the Mother and Child Centre of the Chantal Biya Foundation in Yaoundé (CME-FCB), Cameroon. METHODS A cross-sectional study was conducted in HIVIA aged 10 to 19 years, followed at CME-FCB during the period from December 2021 to March 2022. Sociodemographic, clinical, and mental characteristics were collected using a structured questionnaire administered face-to-face by trained healthcare providers. The primary outcome was viral load ≥ 40 copies/mL in HIVIA on ART for at least six months. The secondary outcome was poor ART adherence, defined as ≥ 1 missed dose of antiretroviral therapy within the last past three days. The main exposure variables were mental health disorders, including the level of anxiety, depression and low self-esteem. RESULTS In total, 302 adolescents were interviewed, 159 (52.7 %) were girls and median age was 15.2 years (IQR: 12.0-17.5). Having missed at least 1 dose of ART drugs during the last 3 days before screening concerned 53 (35.0 %) cases. Of the 247 adolescents with an available viral load (VL) in the last 12 months prior to screening, 33 (26.7 %) had a VL ≥ 40 copies/mL. Among participating adolescents, 29.1 % presented with high or very high anxiety, 26.5 % with severe depression, 36.4 % with history of suicidal ideation, and 20.5 % low self-esteem. Low self-esteem was strongly associated with a higher risk of poor ART adherence (adjusted odds ratio(aOR) (95 % confidence interval (95 %CI)): 2.2 (1.1-4.3); p = 0.022). Living with the father (aOR (95 %CI): 0.6 (0.3-1.1); p = 0.085) or in a household with a televisor (aOR (95 %CI): 0.5 (0.2-1.1); p = 0.069) were slightly associated with a lower risk of poor adherence to ART. Having both parents alive (aOR (95 %CI): 0.4 (0.2-0.9); p = 0.031) or receiving ART with efavirenz or dolutegravir (aOR (95 %CI): 0.5 (0.2-0.9); p = 0.047) was strongly associated with a lower likelihood of having a detectable VL. Moreover, detectable viral load was slightly less frequent in adolescents whose household was equipped with a television (p = 0.084) or who were completely disclosed for HIV status (p = 0.070). CONCLUSION This study found that co-morbid low self-esteem had higher odds of poor ART adherence in HIVIA. Moreover, both poor ART adherence, and detectable viral load were associated with impaired life conditions in HIVIA.
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Affiliation(s)
- Francis Ateba Ndongo
- University of Garoua, Cameroon; Centre Mère-enfant, Fondation Chantal Biya, Yaounde, Cameroon; Ministry of Public Health, Yaounde, Cameroun.
| | - Rogacien Kana
- Media Convergence Consulting Office, Yaounde, Cameroon
| | - Marius Tchassep Nono
- Action for Youths and Family, Douala, Cameroon; University of Douala, Douala, Cameroon
| | | | | | | | | | - Justin Ndie
- Ministry of Public Health, Yaounde, Cameroun
| | | | | | | | | | | | | | | | - Philippe Msellati
- Research Institute for Sustainable Development (IRD), Abidjan, Côte d'Ivoire
| | - Marc Lallemant
- Programs for HIV Prevention and Treatment (PHPT) Foundation - Research Institute for Sustainable Development (IRD), Paris, France
| | - Albert Faye
- Hôpital Universitaire Robert Debré, Paris, France
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Ndongo FA, Kana R, Nono MT, Noah JPYA, Ndzie P, Tejiokem MC, Biheng EH, Ndie J, Nkoa TA, Ketchaji A, Pamen JB, Penda CI, Bissek ACZK, Ndombo POK, Hawa HM, Lallemant M, Faye A. [Problèmes de santé mentale chez les adolescents camerounais infectés par le VIH par voie verticale]. Rev Epidemiol Sante Publique 2023; 71:101422. [PMID: 36706703 DOI: 10.1016/j.respe.2022.101422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/07/2022] [Accepted: 12/16/2022] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Adolescents living with HIV are more likely to experience mental health challenges compared to their peers who do not have HIV. However, there is a lack of data regarding the mental health of adolescents living with HIV in Cameroon. Understanding risk factors and protective factors that influence mental health amongst adolescents is critical for effective programming. The purpose of this study was to estimate the prevalence and the factors associated with depression in adolescents infected with HIV and receiving ART in a Cameroonian referral hospital. METHODS This was a cross-sectional study which enrolled adolescents perinatally infected with HIV, aged 10-19 years, on antiretroviral treatment and cared for at "Centre Mère et Enfant de la Fondation Chantal Biya", Yaounde, Cameroon. Structured questionnaires, including validated French versions of the Coopersmith Child Depression Inventory (CDI), the Multidimensional Anxiety Scale for Children (MASC) and the Coopersmith Self Esteem Inventory (SEI), were administered to the study participants by the healthcare providers. RESULTS All in all, 302 adolescents were recruited in the study at a median age of 15.2 years (interquartile range : 12.0 - 17.5), including 159 (52.7 %) girls. Both parents had died for 57 (18.9 %) adolescents ; only the father was alive for 64 (21.2 %) ; only the mother was alive for 48 (15.9 %), both parents were alive for 133 (44.0 %). This study found prevalence of 26.5 % for severe depression, 36.4 % for suicidal ideation, 29.1 % for high/very high anxiety, and 20.5 % for low self-esteem. No factor was found significantly associated with severe depression but there was a trend towards decreased risk of severe depression among adolescents whose mother was alive [OR= 0.4 (0.1-1.0), p = 0.084]. CONCLUSION This study found that elevated depression, anxiety, and low self-esteem symptoms were prevalent among Cameroonian adolescents perinatally infected with HIV. Services and systems should go beyond clinical management of HIV and address the psychosocial and mental health of adolescents. The indicators of mental health among adolescents infected with HIV should be included in HIV program reporting.
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Affiliation(s)
- Francis Ateba Ndongo
- University of Garoua, Cameroon; Centre Mère-enfant, Fondation Chantal Biya, Yaounde, Cameroon; Ministry of Public Health, Yaounde, Cameroun.
| | - Rogacien Kana
- Media Convergence Consulting Office, Yaounde, Cameroon
| | | | | | | | | | | | - Justin Ndie
- Ministry of Public Health, Yaounde, Cameroun
| | | | | | | | | | | | | | | | - Marc Lallemant
- Programs for HIV Prevention and Treatment (PHPT) Foundation -Research Institute for Sustainable Development (IRD), Paris, France
| | - Albert Faye
- Hôpital Universitaire Robert Debré, Paris, France
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