Speaker
Description
Background
Adolescents and youth living with HIV experience a disproportionate burden of depression and treatment challenges compared to adults. Social support plays a critical protective role in mental health and treatment engagement. However, AYA with elevated depressive symptoms may experience diminished perceived social support. There is limited evidence of the distribution and correlates of perceived social support in this population, which would inform targeted psychosocial interventions.
Methods
Baseline data was analyzed from an ongoing trial conducted across 30 HIV clinics in Kenya. AYA aged 16–24 years with elevated depressive symptoms (Patient Health Questionnaire [PHQ-9] ≥5) were enrolled. Perceived social support was measured using the 12-item Interpersonal Support Evaluation List (ISEL-12) – total (range: 0-36) and subscales: appraisal (range: 0-12), belonging (range: 0-12), and tangible support (range: 0-12). Depressive symptom severity was categorized as mild (PHQ-9 scores: 5-9), moderate (10-19), and severe (≥19). Bivariate regression analyses assessed associations between ISEL-12 scores and key covariates, reporting mean differences (MD) and 95% confidence intervals (CI).
Results
Among 600 AYA enrolled, 66.5% were female and 59.8% were in school, with a median age of 19.6 years (IQR: 17.7 -- 21.9). Treatment adherence was high (85.1%), while 48.7% had experienced physical, emotional or sexual violence. Moderate/severe depressive symptoms affected 35.7%, and anticipated stigma was reported by 53.1%. Median perceived social support scores were 21 (IQR: 17–24) overall, 6 (IQR: 5–9) for appraisal support, 8 (IQR: 6–10) for belonging support and (6 [4–7]) for tangible support.
Compared to those with primary education, secondary education (β=2.30, 95%CI: 0.44–4.16) and college/university education (β=4.32, 95%CI: 1.49–7.15) were associated with higher perceived social support. Lower perceived social support was associated with experienced stigma (β=-1.09, 95%CI: -1.52--0.66), internalized stigma (β=-1.02, 95%CI: -1.46--0.59), perceived stigma (β=-1.03, 95%CI: -1.58--0.48), anticipated stigma (β=-0.81, 95%CI: -1.53--0.09); exposure to violence (β=-1.97, 95%CI: -2.91--1.04), and higher depressive symptoms (β=-0.46, 95%CI: -0.57--0.36). Age, sex, schooling, employment, orphanhood, relationship status, and treatment adherence were not significantly associated with social support.
Conclusion
AYA reported moderate perceived social support, with stronger belonging than tangible support. The findings highlight the need for integrated psychosocial interventions within HIV care that strengthen social support systems while addressing depression, stigma, violence, and educational vulnerability among AYA.