Ramaiya Megan K, Sullivan Kristen A, O' Donnell Karen, Cunningham Coleen K, Shayo Aisa M, Mmbaga Blandina T, Dow Dorothy E
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.
PLoS One. 2016 Nov 16;11(11):e0165936. doi: 10.1371/journal.pone.0165936. eCollection 2016.
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.
尽管85%的艾滋病毒呈阳性的青少年生活在撒哈拉以南非洲，但对于影响他们日常幸福的社会心理和心理健康因素却知之甚少。识别这些背景变量是为这个研究不足的高危人群制定文化上合适且有效的干预措施的关键。本研究的目的是确定坦桑尼亚资源匮乏地区艾滋病毒呈阳性的青年所面临的突出社会心理和心理健康挑战。在坦桑尼亚莫希的一个医疗中心，对24名年龄在12至24岁、接受门诊艾滋病毒护理的青少年进行了便利抽样定性访谈。所有访谈都进行了录音、转录，并采用主题分析法进行编码。确定的社会心理挑战包括失去一位或多位父母、长期遭受家庭虐待、限制获得医疗护理和教育的经济压力源，以及同龄人及其他社会接触者中高度内化的和社区污名化。超过一半的青年（56%）报告称难以接受自己的艾滋病毒诊断，并表达了相关的自责情绪。这些发现凸显了迫切需要制定具有文化能力 的项目，以帮助青少年应对这些多方面的挑战。本研究的结果指导了“青年之声”项目的开发，这是一个为期10节的团体心理健康干预项目，旨在满足坦桑尼亚艾滋病毒呈阳性青年的社会心理和心理健康需求。
