Understanding the experience and manifestation of depression in adolescents living with HIV in Harare, Zimbabwe
Date
2018-01-03
Journal Title
Journal ISSN
Volume Title
Publisher
Public Library of Science
Abstract
Background
Studies have found that adolescents living with HIV are at risk of depression, which in turn affects adherence to medication. This study explored the experience and manifestation of depression in adolescents living with HIV in Zimbabwe in order to inform intervention development.
Methods
We conducted a body mapping exercise with 21 HIV positive 15–19 years olds who had been diagnosed with major depressive disorder. Participants created a painted map of their body to assist them in expressing their somatic and emotional experiences in qualitative interviews. The interviews were transcribed and thematically coded using NVivo 10.
Results
Participants attributed their experiences of depression to their relationships and interactions with significant people in their lives, primarily family members and peers. A sense of being different from others was common among participants, both due to their HIV status and the impact HIV has had on their life circumstances. Participants described a longing to be important or to matter to the people in their lives. A sense of isolation and rejection was common, as well as grief and loss, including ambiguous and anticipated loss. Participants’ idioms of distress included ‘thinking deeply’ (‘kufungisisa’), ‘pain’, darkness, ‘stress’ or a lack of hope and ambiguity for the future. Suicidal ideation was described, including slow suicide through poor adherence. Supportive factors were also relational, including the importance of supportive relatives and peers, clinic staff and psychosocial support programmes.
Conclusions
An understanding of HIV positive adolescents’ own narratives around depression can inform the development and integration of appropriate mental health interventions within HIV care and treatment programmes. Study findings suggest that family and peer-led interventions are potentially useful in the prevention and management of depression in adolescents living with HIV.
Description
CITATION: Willis, N., et al. 2018. Understanding the experience and manifestation of depression in adolescents living with HIV in Harare, Zimbabwe. PLoS ONE, 13(1):e0190423, doi:10.1371/journal.pone.0190423.
The original publication is available at https://journals.plos.org/plosone/
The original publication is available at https://journals.plos.org/plosone/
Keywords
Depression, Adolescent — Mental health, HIV positive people — Adolescents, Harare, Zimbabwe
Citation
Willis, N., et al. 2018. Understanding the experience and manifestation of depression in adolescents living with HIV in Harare, Zimbabwe. PLoS ONE, 13(1):e0190423, doi:10.1371/journal.pone.0190423