The Prevalence and Determinants of Depression and Anxiety Among Adolescents and Young Adults Living with HIV in the Nampula Province, Mozambique

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dc.contributor.advisorMogoba, Pheposadi
dc.contributor.authorBlacher, Ashlee
dc.date.accessioned2026-06-25T09:46:20Z
dc.date.available2026-06-25T09:46:20Z
dc.date.issued2026
dc.date.updated2026-06-25T09:45:02Z
dc.description.abstractAdolescents and young adults living with HIV (AYAHIV) in Mozambique represent a uniquely vulnerable demographic, faced with considerable challenges along the HIV care continuum, which are further compounded by their elevated risk of common mental disorders (CMDs). Despite this dual burden, and the purported deleterious treatment outcomes associated with this comorbidity, research in this context remains scarce. We examined the prevalence and determinants of depressive and anxiety disorder symptoms among AYAHIV in Nampula, Mozambique. This study was informed by cross-sectional data from post-intervention surveys from the CombinADO study, a cluster randomized control trial conducted among 1,715 AYAHIV, aged 10 to 24 years, across 12 clinics in the Nampula Province, Northern Mozambique. 1,358 AYAHIV, aged 1524 years, were included for analysis. We used logistic mixed effects models to assess factors associated with depressive and anxiety disorder symptoms. Among Mozambiquan AYAHIV, 21.7% screened positive for depressive symptoms and 21.1% for anxiety symptoms, with higher rates of anxiety symptoms in females (22.33% vs 16.77%, p=0.035) and higher rates of depressive symptoms in those aged 15-19 years (24.63% vs 19.78%, p=0.034). Key risk factors for depressive symptoms included lower family social support (aOR=1.09, 95% CI: 1.01, 1.17) and higher internalized HIV stigma (aOR=1.33, 95% CI: 1.20, 1.48), while protective factors included being a high-school non-completer and below (aOR=0.32, 95% CI: 0.18, 0.57), higher ART adherence (aOR=0.98, 95% CI: 0.96, 1.00), and lower friend social support (aOR=0.87, 95% CI: 0.82, 0.92). For anxiety symptoms, risk factors included female sex (aOR=2.11, 95% CI: 1.34, 3.33), being in a non-cohabitating romantic relationship (aOR=1.73, 95% CI: 1.11, 2.71), and higher internalized HIV stigma (aOR=1.19, 95% CI: 1.08, 1.30). These findings contribute to the emerging body of evidence on the burden of CMDs among AYAHIV in SSA and Mozambique, underscoring the critical need for targeted mental health services in this setting.
dc.identifier.apacitationBlacher, A. (2026). <i>The Prevalence and Determinants of Depression and Anxiety Among Adolescents and Young Adults Living with HIV in the Nampula Province, Mozambique</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/43383en_ZA
dc.identifier.chicagocitationBlacher, Ashlee. <i>"The Prevalence and Determinants of Depression and Anxiety Among Adolescents and Young Adults Living with HIV in the Nampula Province, Mozambique."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2026. http://hdl.handle.net/11427/43383en_ZA
dc.identifier.citationBlacher, A. 2026. The Prevalence and Determinants of Depression and Anxiety Among Adolescents and Young Adults Living with HIV in the Nampula Province, Mozambique. . University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/43383en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Blacher, Ashlee AB - Adolescents and young adults living with HIV (AYAHIV) in Mozambique represent a uniquely vulnerable demographic, faced with considerable challenges along the HIV care continuum, which are further compounded by their elevated risk of common mental disorders (CMDs). Despite this dual burden, and the purported deleterious treatment outcomes associated with this comorbidity, research in this context remains scarce. We examined the prevalence and determinants of depressive and anxiety disorder symptoms among AYAHIV in Nampula, Mozambique. This study was informed by cross-sectional data from post-intervention surveys from the CombinADO study, a cluster randomized control trial conducted among 1,715 AYAHIV, aged 10 to 24 years, across 12 clinics in the Nampula Province, Northern Mozambique. 1,358 AYAHIV, aged 1524 years, were included for analysis. We used logistic mixed effects models to assess factors associated with depressive and anxiety disorder symptoms. Among Mozambiquan AYAHIV, 21.7% screened positive for depressive symptoms and 21.1% for anxiety symptoms, with higher rates of anxiety symptoms in females (22.33% vs 16.77%, p=0.035) and higher rates of depressive symptoms in those aged 15-19 years (24.63% vs 19.78%, p=0.034). Key risk factors for depressive symptoms included lower family social support (aOR=1.09, 95% CI: 1.01, 1.17) and higher internalized HIV stigma (aOR=1.33, 95% CI: 1.20, 1.48), while protective factors included being a high-school non-completer and below (aOR=0.32, 95% CI: 0.18, 0.57), higher ART adherence (aOR=0.98, 95% CI: 0.96, 1.00), and lower friend social support (aOR=0.87, 95% CI: 0.82, 0.92). For anxiety symptoms, risk factors included female sex (aOR=2.11, 95% CI: 1.34, 3.33), being in a non-cohabitating romantic relationship (aOR=1.73, 95% CI: 1.11, 2.71), and higher internalized HIV stigma (aOR=1.19, 95% CI: 1.08, 1.30). These findings contribute to the emerging body of evidence on the burden of CMDs among AYAHIV in SSA and Mozambique, underscoring the critical need for targeted mental health services in this setting. DA - 2026 DB - OpenUCT DP - University of Cape Town KW - Adolescents and young adults living with HIV (AYAHIV) KW - mental health KW - depression KW - anxiety KW - determinants KW - Mozambique LK - https://open.uct.ac.za PB - University of Cape Town PY - 2026 T1 - The Prevalence and Determinants of Depression and Anxiety Among Adolescents and Young Adults Living with HIV in the Nampula Province, Mozambique TI - The Prevalence and Determinants of Depression and Anxiety Among Adolescents and Young Adults Living with HIV in the Nampula Province, Mozambique UR - http://hdl.handle.net/11427/43383 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/43383
dc.identifier.vancouvercitationBlacher A. The Prevalence and Determinants of Depression and Anxiety Among Adolescents and Young Adults Living with HIV in the Nampula Province, Mozambique. []. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2026 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/43383en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectAdolescents and young adults living with HIV (AYAHIV)
dc.subjectmental health
dc.subjectdepression
dc.subjectanxiety
dc.subjectdeterminants
dc.subjectMozambique
dc.titleThe Prevalence and Determinants of Depression and Anxiety Among Adolescents and Young Adults Living with HIV in the Nampula Province, Mozambique
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMPH
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