Mental health in South African adolescents living with HIV: correlates of internalising and externalising symptoms

Boyes, Mark E.; Cluver, Lucie D.; Meinck, Franziska; Casale, Marisa; Newnham, Elizabeth

doi:10.1080/09540121.2018.1524121

Cited by 55HIV/AIDS Research and InterventionsChild and Adolescent Psychosocial and Emotional DevelopmentAdolescent Sexual and Reproductive Health

Mental health in South African adolescents living with HIV: correlates of internalising and externalising symptoms

Boyes, Mark E., Cluver, Lucie D., Meinck, Franziska, Casale, Marisa, Newnham, Elizabeth·2019·AIDS Care

DOI 10.1080/09540121.2018.1524121

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Abstract

Although declining in all other age groups, AIDS-related deaths among adolescents are increasing. In the context of HIV, mental health problems are associated with negative health outcomes, including non-adherence to life-saving ART. For effective programming it is essential to identify factors associated with psychological outcomes in this population. Adopting a socioecological perspective, we aimed to identify correlates of internalising and externalising symptoms in a large, representative sample of South African adolescents living with HIV. HIV-positive adolescents (n = 1060), who received care in public health facilities in South Africa's Eastern Cape, completed measures of internalising and externalising symptoms. Hypothesised correlates included HIV and health-related factors (physical health, mode of infection, medication side-effects, disclosure, stigma), health-service related factors (negative interactions with clinic staff, clinic support group), interpersonal factors (abuse, bullying victimisation, social support), parenting-related factors (orphanhood, positive parenting, parental monitoring, parent communication), as well as individual and demographic-related factors (self-efficacy, age, gender, urban/rural location, poverty). Correlates operating across a variety of contexts were identified. Bullying victimisation, self-efficacy, and positive parenting may be particularly salient intervention targets as they were associated with better outcomes on most or all…

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Boyes et al. (2019) reported that positive parental monitoring was associated with fewer symptoms of depression, anxiety, and PTSD with small effect sizes (β = -0.11, -0.09, -0.21; p < 0.001, p < 0.01, p < 0.001, respectively) among 1060 South African ALHIV.
“Boyes et al. (2019) ( n = 1060 South African ALHIV) reported that positive parental monitoring was associated with fewer symptoms of depression, anxiety and PTSD with small effect sizes ( β = -0.11, p < 0.001), ( β = -0.09, p < 0.01 and β = -0.21, p < 0.001, respectively).”
From Resilience resources for mental health among people living with HIV: a mixed-method systematic review (2024) · cites this paper as Boyes et al., 2019
The review infers that differences between Boyes et al. and Casale et al. findings on support group attendance are probably attributable to variations in methodological approach, such as Casale et al. including more explanatory factors which likely attenuated associations.
“The differences in the observed findings are probably attributable to variations in methodological approach, for example, Casale et al., included a greater number of potential explanatory factors in their correlation and regression models, which likely acted to attenuate associations.”
From Resilience resources for mental health among people living with HIV: a mixed-method systematic review (2024) · cites this paper as Boyes et al., 2019
Among adolescents living with HIV (ALHIV) in South Africa, self-efficacy was weakly associated with lower levels of depression (β = -0.07, p < 0.05) (Boyes et al., 2019).
“One study reported that self-efficacy was weakly associated with lower levels of depression ( β = -0.07, p < 0.05) and anxiety ( β = -0.07, p < 0.01) among adolescents living with HIV (ALHIV) in South Africa (Boyes et al., 2019).”
From Resilience resources for mental health among people living with HIV: a mixed-method systematic review (2024) · cites this paper as Boyes et al., 2019
Boyes et al. (2019) found that accessing a clinic support group was weakly associated with lower levels of depression (β = -0.09, p < 0.01) and anxiety (β = -0.08, p < 0.01) symptoms among 1060 ALHIV from South Africa.
“A study of 1060 ALHIV from South Africa found that accessing a clinic support group was weakly associated with lower levels of depression ( β = -0.09, p < 0.01) and anxiety ( β = -0.08, p < 0.01) symptoms (Boyes et al., 2019).”
From Resilience resources for mental health among people living with HIV: a mixed-method systematic review (2024) · cites this paper as Boyes et al., 2019
Three studies included adolescents (10-19 age range).
“Three studies (Boyes et al., 2019; Casale et al., 2019; Woollett et al., 2016) included adolescents (10-19 age range).”
From Resilience resources for mental health among people living with HIV: a mixed-method systematic review (2024) · cites this paper as Boyes et al., 2019

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Authors: Boyes, M. E., Cluver, L. D., Meinck, F., Casale, M., & Newnham, E.
Affiliations: Curtin University (AU)
University of Cape Town (ZA)
North-West University (ZA)
University of Oxford (GB)
Harvard University (US)
Corresponding author: Boyes, Mark E.
ORCID: Boyes, Mark E.
Cluver, Lucie D.
Meinck, Franziska
Casale, Marisa
Newnham, Elizabeth
Venue: AIDS Care
Publisher: Informa UK Limited
Published: 2018-09-21
Volume: 31
Issue: 1
Pages: 95-104
ISSN: 0954-0121 (ISSN-L)
1360-0451
DOI: 10.1080/09540121.2018.1524121
OpenAlex: W2892447554
Cited by: 55
References: 60
Citations by year: 2026: 4 · 2025: 6 · 2024: 6 · 2023: 12 · 2022: 6 · 2021: 15 · 2020: 4 · 2019: 2
FWCI: 3.96
Type: journal article
Language: en
Open access: closed
Locations: AIDS Care (publishedVersion)
PubMed (publishedVersion)
eSpace (Curtin University) (submittedVersion)
UWC Research Repository (University of the Western Cape) (submittedVersion)
Funders: Mott MacDonald (MM/EHPSA/UCT/05150014)
Johnson and Johnson
International AIDS Society (155-Hod)
Clarendon-Green Templeton College Scholarship
European Research Council (ERC)
European Union's Seventh Framework Programme (FP7/2007-2013/ERC grant agreement no 313421)
Philip Leverhulme Trust (PLP-2014-095)
Department of Health (Western Australia)
Curtin Research Fellowship
Economic and Social Research Council (ESRC, ES/N017447/1)
ESRC Impact Acceleration Account Support (1602-KEA-189, 1311-KEA-004 & 1069-GCRF-227)
Nuffield Foundation (CPF/41513)
Topics: Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
Keywords: adolescents living with HIV, adolescent mental health, internalizing problems, externalising symptoms, bullying victimization, self-efficacy, positive parenting, parental supervision, parental communication, orphanhood, HIV stigma, disclosure, antiretroviral therapy adherence, socio-ecological model, South Africa
MeSH terms: Adolescent, Anxiety, Depression, Female, Humans, Male, Mental Health, Poverty, Residence Characteristics, Social Support, South Africa, Stress Disorders, Post-Traumatic, HIV Infections, Anti-HIV Agents, Conduct Disorder, Black People, Young Adult, Social Stigma

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Mental health in South African adolescents living with HIV: correlates of internalising and externalising symptoms

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