Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr:4:100094.
doi: 10.1016/j.jadr.2021.100094. Epub 2021 Jan 23.

Childhood trauma, major depressive disorder, suicidality, and the modifying role of social support among adolescents living with HIV in rural Uganda

Scholastic Ashaba  1 , Christine Cooper-Vince  2 , Samuel Maling  1 , Emily N Satinsky  1   3 , Charles Baguma  1 , Dickens Akena  4 , Denis Nansera  1 , Francis Bajunirwe  1 , Alexander C Tsai  1   3   5
Affiliations

Childhood trauma, major depressive disorder, suicidality, and the modifying role of social support among adolescents living with HIV in rural Uganda

Scholastic Ashaba et al. J Affect Disord Rep. 2021 Apr.

Abstract

Background: Childhood trauma is associated with mental health problems among adolescents living with HIV (ALHIV) in sub-Saharan Africa, but little is known about potential moderating factors.

Methods: We enrolled 224 ALHIV aged 13-17 years and collected information on childhood trauma, major depressive disorder, and suicidality. We used modified multivariable Poisson regression to estimate the association between the mental health outcome variables and childhood trauma, and to assess for effect modification by social support.

Results: Major depressive disorder had a statistically significant association with emotional abuse (adjusted relative risk [ARR] 2.57; 95% CI 1.31-5.04; P=0.006) and physical abuse (ARR 2.16; 95% CI 1.19-3.89; P=0.01). The estimated association between any abuse and major depressive disorder was statistically significant among those with a low level of social support (ARR 4.30; 95% CI 1.64-11.25; P=0.003) but not among those with a high level of social support (ARR 1.30; 95% CI 0.57-2.98; P=0.52). Suicidality also had a statistically significant association with emotional abuse (ARR 2.03; 95% CI 1.05-3.920; P=0.03) and physical abuse (ARR 3.17; 95% CI 1.60-6.25.; P=0.001), but no differences by social support were noted.

Limitations: Corporal punishment is used widely in schools and homes as a form of discipline in Uganda; this cultural practice could have biased reporting about physical abuse.

Conclusions: Childhood trauma is associated with poor mental health among ALHIV, but its effects may be moderated by social support. More research is needed to develop social support interventions for ALHIV with adverse childhood experiences for improved mental health outcomes.

Keywords: Adolescents; HIV; Uganda; adverse childhood experiences; mental health; sub-Saharan Africa; trauma.

PubMed Disclaimer

Conflict of interest statement

Disclosure statement The authors have no conflict of interest to declare.

References

    1. Abubakar A, Van de Vijver FJR, Hassan AS, Fischer R, Nyongesa MK, Kabunda B, Berkley JA, Stein A, & Newton CR (2017). Cumulative Psychosocial Risk is a Salient Predictor of Depressive Symptoms among Vertically HIV-Infected and HIV-Affected Adolescents at the Kenyan Coast. Annals of Global Health, 83(5–6), 743–752. - PMC - PubMed
    1. Adejumo OA, Malee KM, Ryscavage P, Hunter SJ, & Taiwo BO (2015). Contemporary issues on the epidemiology and antiretroviral adherence of HIV-infected adolescents in sub-Saharan Africa: a narrative review. Journal of the International AIDS Society, 18(1), 20049. - PMC - PubMed
    1. Adeyemo S, Adeosun II, Ogun OC, Adewuya A, David AN, Adegbohun AA, Adejumo O, Ogunlowo OA, & Adeyemo OO (2020). Depression and suicidality among adolescents living with human immunodeficiency virus in Lagos, Nigeria. Child and Adolescent Psychiatry and Mental Health, 14(1), 1–10. - PMC - PubMed
    1. Ashaba S, Cooper-Vince C, Maling S, Rukundo G, Akena D, & Tsai A (2018). Internalized HIV stigma, bullying, major depressive disorder, and high-risk suicidality among HIV-positive adolescents in rural Uganda. Global Mental Health, 5, e22, 1–10. - PMC - PubMed
    1. Ashaba S, Cooper-Vince C, Vořechovská D, Maling S, Rukundo GZ, Akena D, & Tsai AC (2019a). Development and validation of a 20-item screening scale to detect major depressive disorder among adolescents with HIV in rural Uganda: a mixed-methods study. SSM-population health, 7, 100332. - PMC - PubMed