title: Mental health and disclosure of HIV status in Zambian adolescents with HIV infection: implications for peer-support programs.
abstract: OBJECTIVE
  To examine emotional and behavioural difficulties in HIV positive Zambian adolescents and to determine the relationship between disclosure of HIV status and mental health.
  
  
  METHODS
  A cross-sectional survey.
  
  
  METHODS
  Participants were 127 HIV positive adolescents aged 11 to 15 years recruited through clinics in the Lusaka region. Mental health was assessed using the youth report version of the Strengths and Difficulties Questionnaire (SDQ). Caregivers completed the parent SDQ. Sixty-two participants were invited for a semi-structured interview which probed views on attending a peer support group.
  
  
  RESULTS
  Compared to a British community sample participants had increased mental health problems (OR, 2.1), particularly emotional symptoms (OR = 3.6) and peer problems (OR = 7.1). The majority of children (n = 94) were receiving antiretroviral (ARV) treatment, but only 48 children (37.8%) had their HIV status disclosed. Those who had not had their HIV status disclosed were younger (P < 0.001) and less likely to be receiving ARV treatment (P < 0.001). Controlling for these factors they were also more likely to score in the abnormal range of the emotional difficulties subscale (OR = 2.63, 95% CI: 1.11 to 6.26). Of 38 interviews transcribed, content analysis showed that only 3 children were opposed to participation in a peer-group program, with the majority (23/38) expressing reasoned and positive responses, regardless of disclosure status.
  
  
  CONCLUSIONS
  High rates of emotional and peer problems were found in this sample but disclosure of HIV status did not have a negative effect on mental health. Interventions to promote disclosure could facilitate access to emotional and peer support.
authors.affiliation: Department of Psychology, University of Zambia, Lusaka, Zambia.
authors.forename: Anitha
authors.initials: A
authors.lastname: Menon
authors.forename: Cristine
authors.initials: C
authors.lastname: Glazebrook
authors.forename: Nicholas
authors.initials: N
authors.lastname: Campain
authors.forename: Mary
authors.initials: M
authors.lastname: Ngoma
mesh_terms: D000293:Adolescent; D002648:Child; D005190:Family; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006679:HIV Seropositivity / Q000523:psychology; D006801:Humans; D008297:Male; D008603:Mental Health; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D015024:Zambia