Zambart, Lusaka, Zambia.
London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLoS One. 2022 Dec 1;17(12):e0278291. doi: 10.1371/journal.pone.0278291. eCollection 2022.
Mental health is a critical and neglected public health problem for adolescents in sub-Saharan Africa. In this paper we aim to determine the prevalence of depressive symptoms and the association with HIV risk behaviours in adolescents aged 15-19 years in Zambia and SA.
We conducted a cross-sectional survey from August-November 2017 in seven control communities of HPTN 071 (PopART) trial (a community-randomised trial of universal HIV testing and treatment), enrolling approximately 1400 eligible adolescents. HIV-status was self-reported. Depressive symptoms were measured with the Short Mood and Feelings Questionnaire (SMFQ), with a positive screen if adolescents scored ≥12. We fitted a logistic regression model to identify correlates of depressive symptoms with subgroup analyses among those who self-reported ever having had sex, by gender and country.
Out of 6997 households approached, 6057 (86.6%) were enumerated. 2546 adolescents were enumerated of whom 2120 (83.3%) consented to participate and were administered the SMFQ. The prevalence of depressive symptoms was 584/2120 (27.6%) [95%CI: 25.7%-29.5%]. Adolescents in SA were less likely to experience depressive symptoms (Adjusted Odds Ratio [AOR] = 0.63 (95% CI: 0.50, 0.79), p-value<0.0001). Female adolescents (AOR = 1.46 (95% CI: 1.19, 1.81), p-value<0.0001); those who reported ever having sex and being forced into sex (AOR = 1.80 (95% CI: 1.45, 2.23), p-value<0.001) and AOR = 1.67 (95% CI: 0.99, 2.84); p-value = 0.057 respectively) were more likely to experience depressive symptoms. Among 850 (40.1%) adolescents who self-reported to ever having had sex; those who used alcohol/drugs during their last sexual encounter were more likely to experience depressive symptoms (AOR = 2.18 (95% CI: 1.37, 3.47); p-value = 0.001), whereas those who reported using a condom were less likely to experience depressive symptoms (AOR = 0.74 (95% CI: 0.55, 1.00); p-value = 0.053).
The prevalence of depressive symptoms among adolescents ranged from 25-30% and was associated with increased HIV-risk behaviour.
心理健康是撒哈拉以南非洲青少年的一个严重而被忽视的公共卫生问题。本文旨在确定赞比亚和南非 15-19 岁青少年中抑郁症状的流行率及其与艾滋病毒风险行为的关系。
我们于 2017 年 8 月至 11 月在 HPTN 071（PopART）试验（一项针对普遍艾滋病毒检测和治疗的社区随机试验）的七个对照社区进行了一项横断面调查，共招募了约 1400 名符合条件的青少年。艾滋病毒状况为自我报告。使用短期情绪和感觉问卷（SMFQ）测量抑郁症状，如果青少年得分≥12 分，则为阳性筛查。我们拟合了一个逻辑回归模型，以确定抑郁症状的相关因素，并在报告有过性行为的青少年中进行了亚组分析，按性别和国家进行分析。
在接触的 6997 户家庭中，有 6057 户（86.6%）进行了普查。在 2546 名被普查的青少年中，有 2120 名（83.3%）同意参加并接受了 SMFQ 调查。抑郁症状的流行率为 584/2120（27.6%）[95%CI：25.7%-29.5%]。南非青少年出现抑郁症状的可能性较低（调整后的优势比[OR] = 0.63（95%CI：0.50，0.79），p 值<0.0001）。女性青少年（OR = 1.46（95%CI：1.19，1.81），p 值<0.0001）；报告有过性行为且曾被迫发生性行为的青少年（OR = 1.80（95%CI：1.45，2.23），p 值<0.001）和 OR = 1.67（95%CI：0.99，2.84）；p 值=0.057）更有可能出现抑郁症状。在 850 名（40.1%）报告有过性行为的青少年中；那些在最近一次性行为中使用酒精/药物的青少年更有可能出现抑郁症状（OR = 2.18（95%CI：1.37，3.47）；p 值=0.001），而那些报告使用安全套的青少年出现抑郁症状的可能性较低（OR = 0.74（95%CI：0.55，1.00）；p 值=0.053）。
青少年抑郁症状的流行率在 25-30%之间，与艾滋病毒风险行为增加有关。
