Investigating the Prevalence and Predictors of Depression and Anxiety Disorders among Adolescents Living with HIV at Kabwe Women, Newborn and Children’s Hospital and Kabwe Central Hospitals

Abstract

Adolescents living with HIV (ALWHIV) face elevated risks of common mental disorders (CMDs), yet limited data exists on their prevalence and determinants in sub-Saharan Africa, particularly Zambia. This study examined the prevalence and factors associated with depression and anxiety among adolescents living with HIV in Kabwe, Zambia. A hospital-based cross-sectional study was conducted among 108 adolescents aged 10–19 years receiving antiretroviral therapy at two public referral hospitals in Kabwe, Zambia. Depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) scale respectively, both validated for use in sub-Saharan African adolescent populations. Bivariate analyses using chi-square tests and multivariate logistic regression were conducted to identify independent predictors of each condition. The prevalence of depression was 26.9% and anxiety was 28.7%, with 17.6% experiencing both conditions concurrently. Experienced stigma and discrimination emerged as the strongest predictor for both depression (AOR=5.87) and anxiety (AOR=4.19). Perception that mental health was affected by social environment independently predicted both conditions. Depression-specific risk factors included living arrangements, with adolescents not living with parents showing threefold increased odds. For anxiety, low confidence in managing HIV treatment was a unique predictor (AOR=2.64). Cumulative risk analysis revealed a dose-response relationship, with CMD prevalence increasing from 16.1% among those with no risk factors to 84.6% among those with three or more factors. The substantial burden of CMDs among ALWHIV in Zambia, driven primarily by stigma and social environment factors, underscores the urgent need for integrated mental health services within HIV care programs. Interventions should address stigma reduction, strengthen social support systems, and provide targeted support for adolescents with multiple vulnerabilities. Keywords: Adolescents, HIV, depression, anxiety, stigma, Zambia