title: A Qualitative Exploration of the Mental Health and Psychosocial Contexts of HIV-Positive Adolescents in Tanzania.
abstract: Although 85% of HIV-positive adolescents reside in sub-Saharan Africa, little is known about the psychosocial and mental health factors affecting their daily well-being. Identifying these contextual variables is key to development of culturally appropriate and effective interventions for this understudied and high-risk population. The purpose of this study was to identify salient psychosocial and mental health challenges confronted by HIV-positive youth in a resource-poor Tanzanian setting. A total of 24 qualitative interviews were conducted with a convenience sample of adolescents aged 12-24 receiving outpatient HIV care at a medical center in Moshi, Tanzania. All interviews were audio-recorded, transcribed, and coded using thematic analysis. Psychosocial challenges identified included loss of one or more parents, chronic domestic abuse, financial stressors restricting access to medical care and education, and high levels of internalized and community stigma among peers and other social contacts. Over half of youth (56%) reported difficulties coming to terms with their HIV diagnosis and espoused related feelings of self-blame. These findings highlight the urgent need to develop culturally proficient programs aimed at helping adolescents cope with these manifold challenges. Results from this study guided the development of Sauti ya Vijana (The Voice of Youth), a 10-session group mental health intervention designed to address the psychosocial and mental health needs of HIV-positive Tanzanian youth.
authors.affiliation: Center for Health Policy & Inequalities Research, Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.|Department of Psychology, University of Washington, Seattle, Washington, United States of America.
authors.forename: Megan K
authors.identifier: http://orcid.org/0000-0003-1489-0991
authors.initials: MK
authors.lastname: Ramaiya
authors.affiliation: Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Sullivan
authors.affiliation: Center for Health Policy & Inequalities Research, Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.|Center for Child & Family Health, Duke University, Durham, North Carolina, United States of America.
authors.forename: Karen
authors.initials: K
authors.lastname: O' Donnell
authors.affiliation: Department of Pediatrics, Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina, United States of America.
authors.forename: Coleen K
authors.initials: CK
authors.lastname: Cunningham
authors.affiliation: Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
authors.forename: Aisa M
authors.initials: AM
authors.lastname: Shayo
authors.affiliation: Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
authors.forename: Blandina T
authors.initials: BT
authors.lastname: Mmbaga
authors.affiliation: Department of Pediatrics, Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina, United States of America.|Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
authors.forename: Dorothy E
authors.initials: DE
authors.lastname: Dow
mesh_terms: D000293:Adolescent; D006679:HIV Seropositivity / Q000523:psychology*; D006266:Health Education; D006801:Humans; D055118:Medication Adherence; D008603:Mental Health; D000067074:Peer Influence; D057545:Social Stigma; D012944:Social Support; D013636:Tanzania; D014754:Violence; D055815:Young Adult