Depression and Incident HIV in Adolescent Girls and Young Women in HPTN 068: Targets for Prevention and Mediating Factors

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Citation

Goin, Dana E.; Pearson, Rebecca M.; Craske, Michelle G.; Stein, Alan; Pettifor, Audrey E.; Lippman, Sheri A.; Kahn, Kathleen; Neilands, Torsten B.; Hamilton, Erica L.; & Selin, Amanda J., et al. (2020). Depression and Incident HIV in Adolescent Girls and Young Women in HPTN 068: Targets for Prevention and Mediating Factors. American Journal of Epidemiology, 189(5), 422-432. PMCID: PMC7306677

Abstract

The human immunodeficiency virus (HIV) epidemic among adolescent girls and young women (AGYW) in sub-Saharan Africa is a critical public health problem. We assessed whether depressive symptoms in AGYW were longitudinally associated with incident HIV, and identified potential social and behavioral mediators. Data came from a randomized trial of a cash transfer conditional on school attendance among AGYW (ages 13 - 21) in rural Mpumalanga Province, South Africa during 2011-2017. We estimated the relationship between depressive symptoms and cumulative HIV incidence using a linear probability model, and assessed mediation using inverse odds ratio weighting. Inference was calculated using the non-parametric bootstrap. AGYW with depressive symptoms had higher cumulative incidence of HIV compared to those without (risk difference = 3.5 [95% CI 0.1, 7.0]). The strongest individual mediators of this association were parental monitoring and involvement (indirect effect = 1.6 [95% CI 0.0, 3.3]) and reporting a partner would hit her if she asked him to wear a condom (indirect effect = 1.5 [95% CI -0.3, 3.3]). All mediators jointly explained two-thirds (indirect effect = 2.4 [95% CI 0.2, 4.5]) of the association between depressive symptoms and HIV incidence. Interventions addressing mental health may reduce risk of acquiring HIV among AGYW.

URL

http://dx.doi.org/10.1093/aje/kwz238

Reference Type

Journal Article

Year Published

2020

Journal Title

American Journal of Epidemiology

Author(s)

Goin, Dana E.
Pearson, Rebecca M.
Craske, Michelle G.
Stein, Alan
Pettifor, Audrey E.
Lippman, Sheri A.
Kahn, Kathleen
Neilands, Torsten B.
Hamilton, Erica L.
Selin, Amanda J.
MacPhail, Catherine Lorne
Wagner, Ryan G.
Gomez-Olive, F. Xavier
Twine, Rhian
Hughes, James P.
Agyei, Yaw
Laeyendecker, Oliver B.
Tollman, Stephen M.
Ahern, Jennifer

Article Type

Regular

PMCID

PMC7306677

Data Set/Study

HIV Prevention Trials Network (HPTN)

Continent/Country

Sub-Saharan Africa
South Africa

Sex/Gender

Women

ORCiD

Pettifor - 0000-0002-3387-0817