{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:53:00Z","timestamp":1792821180667,"version":"4.5.0"},"reference-count":86,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T00:00:00Z","timestamp":1632700800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T00:00:00Z","timestamp":1632700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000279","name":"Nuffield Foundation","doi-asserted-by":"publisher","award":["CPF\/41513"],"award-info":[{"award-number":["CPF\/41513"]}],"id":[{"id":"10.13039\/501100000279","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UKRI GCRF","award":["ES\/S008101\/1"],"award-info":[{"award-number":["ES\/S008101\/1"]}]},{"name":"Mott MacDonald"},{"name":"Janssen Pharmaceutica NV"},{"DOI":"10.13039\/100006641","name":"UNICEF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006641","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007936","name":"International AIDS Society","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007936","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001337","name":"Claude Leon Foundation","doi-asserted-by":"publisher","award":["08 559\/C"],"award-info":[{"award-number":["08 559\/C"]}],"id":[{"id":"10.13039\/501100001337","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001275","name":"Oak Foundation","doi-asserted-by":"publisher","award":["R46194\/AA001"],"award-info":[{"award-number":["R46194\/AA001"]}],"id":[{"id":"10.13039\/100001275","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004789","name":"John Fell Fund, University of Oxford","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004789","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000269","name":"Economic and Social Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000275","name":"Leverhulme Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000275","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000278","name":"Department for International Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000278","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Claredon-Green Templeton College"},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Medical Research Council Australia","award":["1173043"],"award-info":[{"award-number":["1173043"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["AIDS Behav"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The mental health of adolescents (10\u201319\u00a0years) remains an overlooked global health issue, particularly within the context of syndemic conditions such as HIV and pregnancy. Rates of pregnancy and HIV among adolescents within South Africa are some of the highest in the world. Experiencing pregnancy and living with HIV during adolescence have both been found to be associated with poor mental health within separate explorations. Yet, examinations of mental health among adolescents living with HIV who have experienced pregnancy\/parenthood remain absent from the literature. As such, there exists no evidence-based policy or programming relating to mental health for this group. These analyses aim to identify the prevalence of probable common mental disorder among adolescent mothers and, among adolescents experiencing the syndemic of motherhood and HIV. Analyses utilise data from interviews undertaken with 723 female adolescents drawn from a prospective longitudinal cohort study of adolescents living with HIV (n\u2009=\u20091059) and a comparison group of adolescents without HIV (n\u2009=\u2009467) undertaken within the Eastern Cape Province, South Africa. Detailed study questionnaires included validated and study specific measures relating to HIV, adolescent motherhood, and mental health. Four self-reported measures of mental health (depressive, anxiety, posttraumatic stress, and suicidality symptomology) were used to explore the concept of likely common mental disorder and mental health comorbidities (experiencing two or more common mental disorders concurrently). Chi-square tests (Fisher\u2019s exact test, where appropriate) and Kruskal Wallis tests were used to assess differences in sample characteristics (inclusive of mental health status) according to HIV status and motherhood status. Logistic regression models were used to explore the cross-sectional associations between combined motherhood and HIV status and, likely common mental disorder\/mental health comorbidities. 70.5% of participants were living with HIV and 15.2% were mothers. 8.4% were mothers living with HIV. A tenth (10.9%) of the sample were classified as reporting a probable common mental disorder and 2.8% as experiencing likely\u00a0mental health comorbidities. Three core findings emerge: (1) poor mental health was elevated among adolescent mothers compared to never pregnant adolescents (measures of likely common mental disorder, mental health comorbidities, depressive, anxiety and suicidality symptoms), (2) prevalence of probable common mental disorder was highest among mothers living with HIV (23.0%) compared to other groups (Range:8.5\u201312.8%; \u03a7<jats:sup>2<\/jats:sup>\u2009=\u200912.54, p\u2009=\u20090.006) and, (3) prevalence of probable mental health comorbidities was higher among mothers, regardless of HIV status (HIV &amp; motherhood\u2009=\u20098.2%, No HIV &amp; motherhood\u2009=\u20098.2%, \u03a7<jats:sup>2<\/jats:sup>\u2009=\u200914.5, p\u2009=\u20090.002). Results identify higher mental health burden among adolescent mothers compared to never-pregnant adolescents, an increased prevalence of mental health burden among adolescent mothers living with HIV compared to other groups, and an elevated prevalence of mental health comorbidities among adolescent mothers irrespective of HIV status. These findings address a critical evidence gap, highlighting the commonality of mental health burden within the context of adolescent motherhood and HIV within South Africa as well as the urgent need for support and further research to ensure effective evidence-based programming is made available for this group. Existing antenatal, postnatal, and HIV care may provide an opportunity for mental health screening, monitoring, and referral.<\/jats:p>","DOI":"10.1007\/s10461-021-03474-8","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T04:03:00Z","timestamp":1632715380000},"page":"1197-1210","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Adolescent Motherhood and HIV in South Africa: Examining Prevalence of Common Mental Disorder"],"prefix":"10.1007","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1200-5362","authenticated-orcid":false,"given":"Kathryn J.","family":"Roberts","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colette","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Cluver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elona","family":"Toska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyanai","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Boyes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Sherr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,27]]},"reference":[{"key":"3474_CR1","volume-title":"Adoelscent development","author":"World Health Organization","year":"2017","unstructured":"World Health Organization. Adoelscent development. Geneva: WHO; 2017."},{"key":"3474_CR2","volume-title":"Revision of world population prospects","author":"U Desa","year":"2017","unstructured":"Desa U. Revision of world population prospects. New York: United Nations Secretariat Department of Economic and Social Affairs; 2017."},{"issue":"3","key":"3474_CR3","first-page":"168","volume":"6","author":"RC Kessler","year":"2007","unstructured":"Kessler RC, Angermeyer M, Anthony JC, et al. Lifetime prevalence and age-of-onset distributions of mental disorders in the world health organization\u2019s world mental health survey initiative. World Psychiatry. 2007;6(3):168.","journal-title":"World Psychiatry"},{"issue":"7","key":"3474_CR4","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1001\/archpsyc.60.7.709","volume":"60","author":"J Kim-Cohen","year":"2003","unstructured":"Kim-Cohen J, Caspi A, Moffitt TE, Harrington H, Milne BJ, Poulton R. Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Arch Gen Psychiatry. 2003;60(7):709\u201317.","journal-title":"Arch Gen Psychiatry"},{"issue":"7","key":"3474_CR5","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1001\/archgenpsychiatry.2009.85","volume":"66","author":"WE Copeland","year":"2009","unstructured":"Copeland WE, Shanahan L, Costello EJ, Angold A. Childhood and adolescent psychiatric disorders as predictors of young adult disorders. Arch Gen Psychiatry. 2009;66(7):764\u201372.","journal-title":"Arch Gen Psychiatry"},{"issue":"7","key":"3474_CR6","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1111\/jcpp.12062","volume":"54","author":"WE Copeland","year":"2013","unstructured":"Copeland WE, Adair CE, Smetanin P, et al. Diagnostic transitions from childhood to adolescence to early adulthood. J Child Psychol Psychiatry. 2013;54(7):791\u20139.","journal-title":"J Child Psychol Psychiatry"},{"issue":"9926","key":"3474_CR7","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1016\/S0140-6736(13)62633-1","volume":"383","author":"O Eyre","year":"2014","unstructured":"Eyre O, Thapar A. Common adolescent mental disorders: transition to adulthood. Lancet. 2014;383(9926):1366\u20138.","journal-title":"Lancet"},{"issue":"9","key":"3474_CR8","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1001\/jamapsychiatry.2015.0730","volume":"72","author":"WE Copeland","year":"2015","unstructured":"Copeland WE, Wolke D, Shanahan L, Costello EJ. Adult functional outcomes of common childhood psychiatric problems: a prospective, longitudinal study. JAMA Psychiat. 2015;72(9):892\u20139.","journal-title":"JAMA Psychiat"},{"issue":"9590","key":"3474_CR9","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/S0140-6736(07)61238-0","volume":"370","author":"M Prince","year":"2007","unstructured":"Prince M, Patel V, Saxena S, et al. No health without mental health. Lancet. 2007;370(9590):859\u201377.","journal-title":"Lancet"},{"issue":"9801","key":"3474_CR10","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1016\/S0140-6736(11)60754-X","volume":"378","author":"C Lund","year":"2011","unstructured":"Lund C, De Silva M, Plagerson S, et al. Poverty and mental disorders: breaking the cycle in low-income and middle-income countries. Lancet. 2011;378(9801):1502\u201314.","journal-title":"Lancet"},{"key":"3474_CR11","volume-title":"The power of 18 billion: adolescents, youth, and the transformation of the future","author":"MD Gupta","year":"2014","unstructured":"Gupta MD. The power of 18 billion: adolescents, youth, and the transformation of the future. UNFPA: The State of World Population; 2014."},{"issue":"1","key":"3474_CR12","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1093\/wber\/lhn010","volume":"23","author":"J Das","year":"2009","unstructured":"Das J, Do Q-T, Friedman J, McKenzie D. Mental health patterns and consequences: results from survey data in five developing countries. World Bank Econ Rev. 2009;23(1):31\u201355.","journal-title":"World Bank Econ Rev"},{"issue":"9801","key":"3474_CR13","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1016\/S0140-6736(11)60827-1","volume":"378","author":"C Kieling","year":"2011","unstructured":"Kieling C, Baker-Henningham H, Belfer M, et al. Child and adolescent mental health worldwide: evidence for action. Lancet. 2011;378(9801):1515\u201325.","journal-title":"Lancet"},{"issue":"3","key":"3474_CR14","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/j.1475-3588.2004.00090.x","volume":"9","author":"JP Shatkin","year":"2004","unstructured":"Shatkin JP, Belfer ML. The global absence of child and adolescent mental health policy. Child Adolesc Mental Health. 2004;9(3):104\u20138.","journal-title":"Child Adolesc Mental Health"},{"issue":"9801","key":"3474_CR15","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1016\/S0140-6736(11)61385-8","volume":"378","author":"V Patel","year":"2011","unstructured":"Patel V, Boyce N, Collins PY, Saxena S, Horton R. A renewed agenda for global mental health. Lancet (London, England). 2011;378(9801):1441.","journal-title":"Lancet (London, England)"},{"key":"3474_CR16","volume-title":"Child and adolescent mental health","author":"World Health Organisation","year":"2019","unstructured":"World Health Organisation. Child and adolescent mental health. Geneva: WHO; 2019."},{"issue":"4","key":"3474_CR17","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1017\/S2045796015001158","volume":"26","author":"H Erskine","year":"2017","unstructured":"Erskine H, Baxter A, Patton G, et al. The global coverage of prevalence data for mental disorders in children and adolescents. Epidemiol Psychiatr Sci. 2017;26(4):395\u2013402.","journal-title":"Epidemiol Psychiatr Sci"},{"issue":"3","key":"3474_CR18","first-page":"147","volume":"4","author":"H Remschmidt","year":"2005","unstructured":"Remschmidt H, Belfer M. Mental health care for children and adolescents worldwide: a review. World Psychiatry. 2005;4(3):147.","journal-title":"World Psychiatry"},{"issue":"4","key":"3474_CR19","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1097\/YCO.0b013e3281bc0cf4","volume":"20","author":"ML Belfer","year":"2007","unstructured":"Belfer ML. Critical review of world policies for mental healthcare for children and adolescents. Curr Opin Psychiatry. 2007;20(4):349\u201352.","journal-title":"Curr Opin Psychiatry"},{"issue":"9591","key":"3474_CR20","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/S0140-6736(07)61240-9","volume":"370","author":"V Patel","year":"2007","unstructured":"Patel V, Araya R, Chatterjee S, et al. Treatment and prevention of mental disorders in low-income and middle-income countries. Lancet. 2007;370(9591):991\u20131005.","journal-title":"Lancet"},{"issue":"4","key":"3474_CR21","doi-asserted-by":"crossref","first-page":"325","DOI":"10.34172\/hpp.2020.51","volume":"10","author":"CS Yah","year":"2020","unstructured":"Yah CS, Ndlovu S, Kutywayo A, Naidoo N, Mahuma T, Mullick S. The prevalence of pregnancy among adolescent girls and young women across the Southern African development community economic hub: a systematic review and meta-analysis. Health Promot Perspect. 2020;10(4):325.","journal-title":"Health Promot Perspect"},{"issue":"4","key":"3474_CR22","first-page":"781","volume":"50","author":"DS Elfenbein","year":"2003","unstructured":"Elfenbein DS, Felice ME. Adolescent pregnancy. Pediatr Clin. 2003;50(4):781\u2013800.","journal-title":"Pediatr Clin"},{"issue":"3","key":"3474_CR23","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.jpag.2013.09.008","volume":"27","author":"RS Siegel","year":"2014","unstructured":"Siegel RS, Brandon AR. Adolescents, pregnancy, and mental health. J Pediatr Adolesc Gynecol. 2014;27(3):138\u201350.","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"3474_CR24","doi-asserted-by":"publisher","DOI":"10.1007\/s00115-018-0661-7","author":"B Dahmen","year":"2019","unstructured":"Dahmen B, Konrad K, Jahnen L, Herpertz-Dahlmann B, Firk C. Mental health of teenage mothers: impact on the next generation. Nervenarzt. 2019. https:\/\/doi.org\/10.1007\/s00115-018-0661-7.","journal-title":"Nervenarzt"},{"issue":"3","key":"3474_CR25","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s11920-016-0660-y","volume":"18","author":"TG O\u2019Connor","year":"2016","unstructured":"O\u2019Connor TG, Monk C, Burke AS. Maternal affective illness in the perinatal period and child development: findings on developmental timing, mechanisms, and intervention. Curr Psychiatry Rep. 2016;18(3):24.","journal-title":"Curr Psychiatry Rep"},{"issue":"7","key":"3474_CR26","doi-asserted-by":"crossref","first-page":"1728","DOI":"10.1007\/s10995-013-1418-3","volume":"18","author":"D Kingston","year":"2014","unstructured":"Kingston D, Tough S. Prenatal and postnatal maternal mental health and school-age child development: a systematic review. Matern Child Health J. 2014;18(7):1728\u201341.","journal-title":"Matern Child Health J"},{"issue":"9690","key":"3474_CR27","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/S0140-6736(09)60238-5","volume":"374","author":"P Ramchandani","year":"2009","unstructured":"Ramchandani P, Psychogiou L. Paternal psychiatric disorders and children\u2019s psychosocial development. Lancet. 2009;374(9690):646\u201353.","journal-title":"Lancet"},{"issue":"2","key":"3474_CR28","doi-asserted-by":"crossref","first-page":"e463","DOI":"10.1542\/peds.2012-0804","volume":"131","author":"AL Kvalevaag","year":"2013","unstructured":"Kvalevaag AL, Ramchandani PG, Hove O, Assmus J, Eberhard-Gran M, Biringer E. Paternal mental health and socioemotional and behavioral development in their children. Pediatrics. 2013;131(2):e463-9.","journal-title":"Pediatrics"},{"key":"3474_CR29","volume-title":"South African national HIV prevalence, incidence, behaviour and communication survey, 2017: towards achieving the UNAIDS 90-90-90 targets","author":"L Simbayi","year":"2019","unstructured":"Simbayi L, Zuma K, Zungu N, et al. South African national HIV prevalence, incidence, behaviour and communication survey, 2017: towards achieving the UNAIDS 90-90-90 targets. Cape Town: HSRC Press; 2019."},{"key":"3474_CR30","doi-asserted-by":"publisher","DOI":"10.1017\/gmh.2020.18","author":"AS Dessauvagie","year":"2020","unstructured":"Dessauvagie AS, J\u00f6rns-Presentati A, Napp A-K, et al. The prevalence of mental health problems in sub-Saharan adolescents living with HIV: a systematic review. Global Mental Health. 2020. https:\/\/doi.org\/10.1017\/gmh.2020.18.","journal-title":"Global Mental Health"},{"issue":"4","key":"3474_CR31","doi-asserted-by":"crossref","first-page":"e20153235","DOI":"10.1542\/peds.2015-3235","volume":"138","author":"MCS Fawzi","year":"2016","unstructured":"Fawzi MCS, Ng L, Kanyanganzi F, et al. Mental health and antiretroviral adherence among youth living with HIV in Rwanda. Pediatrics. 2016;138(4):e20153235.","journal-title":"Pediatrics"},{"issue":"7","key":"3474_CR32","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1080\/09540121.2016.1139043","volume":"28","author":"DE Dow","year":"2016","unstructured":"Dow DE, Turner EL, Shayo AM, Mmbaga B, Cunningham CK, O\u2019Donnell K. Evaluating mental health difficulties and associated outcomes among HIV-positive adolescents in Tanzania. AIDS Care. 2016;28(7):825\u201333.","journal-title":"AIDS Care"},{"issue":"2","key":"3474_CR33","doi-asserted-by":"crossref","first-page":"101","DOI":"10.2989\/16085906.2011.593373","volume":"10","author":"E Breuer","year":"2011","unstructured":"Breuer E, Myer L, Struthers H, Joska JA. HIV\/AIDS and mental health research in sub-Saharan Africa: a systematic review. Afr J AIDS Res. 2011;10(2):101\u201322.","journal-title":"Afr J AIDS Res"},{"issue":"3","key":"3474_CR34","doi-asserted-by":"crossref","first-page":"21","DOI":"10.3390\/soc6030021","volume":"6","author":"J Corcoran","year":"2016","unstructured":"Corcoran J. Teenage pregnancy and mental health. Societies. 2016;6(3):21.","journal-title":"Societies"},{"issue":"6","key":"3474_CR35","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1007\/s10461-014-0728-9","volume":"18","author":"S Kapetanovic","year":"2014","unstructured":"Kapetanovic S, Dass-Brailsford P, Nora D, Talisman N. Mental health of HIV-seropositive women during pregnancy and postpartum period: a comprehensive literature review. AIDS Behav. 2014;18(6):1152\u201373.","journal-title":"AIDS Behav"},{"issue":"9","key":"3474_CR36","doi-asserted-by":"crossref","first-page":"e74568","DOI":"10.1371\/journal.pone.0074568","volume":"8","author":"C Horwood","year":"2013","unstructured":"Horwood C, Butler LM, Haskins L, Phakathi S, Rollins N. HIV-infected adolescent mothers and their infants: low coverage of HIV services and high risk of HIV transmission in KwaZulu-Natal, South Africa. PLoS ONE. 2013;8(9):e74568.","journal-title":"PLoS ONE"},{"key":"3474_CR37","doi-asserted-by":"crossref","unstructured":"Roberts KJ, Smith C, Cluver L, Toska E, Sherr L. Understanding mental health in the context of adolescent pregnancy and HIV in sub-Saharan Africa\u2014a systematic review identifying a critical evidence gap. AIDS Behav. 2021. (In press).","DOI":"10.1007\/s10461-020-03138-z"},{"key":"3474_CR38","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-018-1706-y","author":"J Osok","year":"2018","unstructured":"Osok J, Kigamwa P, Stoep AV, Huang KY, Kumar M. Depression and its psychosocial risk factors in pregnant Kenyan adolescents: a cross-sectional study in a community health centre of Nairobi. BMC Psychiatry. 2018. https:\/\/doi.org\/10.1186\/s12888-018-1706-y.","journal-title":"BMC Psychiatry"},{"issue":"6","key":"3474_CR39","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1001\/jamapediatrics.2017.0250","volume":"171","author":"N Kassebaum","year":"2017","unstructured":"Kassebaum N, Kyu HH, Zoeckler L, et al. Child and adolescent health from 1990 to 2015: findings from the global burden of diseases, injuries, and risk factors 2015 study. JAMA Pediatr. 2017;171(6):573\u201392.","journal-title":"JAMA Pediatr"},{"key":"3474_CR40","volume-title":"Adolescent mental health: fact sheet","author":"World Health Organisation","year":"2019","unstructured":"World Health Organisation. Adolescent mental health: fact sheet. Geneva: World Health Organisation (WHO); 2019."},{"issue":"1","key":"3474_CR41","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1186\/s12889-016-3832-0","volume":"16","author":"K Closson","year":"2016","unstructured":"Closson K, Dietrich JJ, Nkala B, et al. Prevalence, type, and correlates of trauma exposure among adolescent men and women in Soweto, South Africa: implications for HIV prevention. BMC Public Health. 2016;16(1):1191.","journal-title":"BMC Public Health"},{"issue":"7","key":"3474_CR42","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.3390\/ijerph15071425","volume":"15","author":"S Bachmann","year":"2018","unstructured":"Bachmann S. Epidemiology of suicide and the psychiatric perspective. Int J Environ Res Public Health. 2018;15(7):1425.","journal-title":"Int J Environ Res Public Health"},{"key":"3474_CR43","volume-title":"Children\u2019s depression inventory (CDI): technical manual update","author":"M Kovacs","year":"2003","unstructured":"Kovacs M, Staff M. Children\u2019s depression inventory (CDI): technical manual update. North Tonawanda: Multi-Health Systems; 2003."},{"key":"3474_CR44","volume-title":"Children\u2019s depression inventory (CDI): technical manual update","author":"M Kovacs","year":"1992","unstructured":"Kovacs M. Children\u2019s depression inventory (CDI): technical manual update. Toronto: Multi-Health Systems; 1992."},{"key":"3474_CR45","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i1981","author":"S Greenland","year":"2016","unstructured":"Greenland S, Mansournia MA, Altman DG. Sparse data bias: a problem hiding in plain sight. BMJ. 2016. https:\/\/doi.org\/10.1136\/bmj.i1981.","journal-title":"BMJ"},{"issue":"1","key":"3474_CR46","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/00004583-199301000-00003","volume":"32","author":"M Kovacs","year":"1993","unstructured":"Kovacs M, Goldston D, Gatsonis C. Suicidal behaviors and childhood-onset depressive disorders: a longitudinal investigation. J Am Acad Child Adolesc Psychiatry. 1993;32(1):8\u201320.","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"3474_CR47","volume-title":"Assessing post-traumatic responses among South African adolescents: a comparison of different methods","author":"S Suliman","year":"2002","unstructured":"Suliman S. Assessing post-traumatic responses among South African adolescents: a comparison of different methods. Cape Town: University of Cape Town; 2002."},{"issue":"5","key":"3474_CR48","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.jpsychores.2012.08.016","volume":"73","author":"A-K Allgaier","year":"2012","unstructured":"Allgaier A-K, Fr\u00fche B, Pietsch K, Saravo B, Baethmann M, Schulte-K\u00f6rne G. Is the children\u2019s depression inventory short version a valid screening tool in pediatric care? A comparison to its full-length version. J Psychosom Res. 2012;73(5):369\u201374.","journal-title":"J Psychosom Res"},{"issue":"2","key":"3474_CR49","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1080\/17450121003668343","volume":"5","author":"D Traube","year":"2010","unstructured":"Traube D, Dukay V, Kaaya S, Reyes H, Mellins C. Cross-cultural adaptation of the child depression inventory for use in Tanzania with children affected by HIV. Vulnerable Child Youth Stud. 2010;5(2):174\u201387.","journal-title":"Vulnerable Child Youth Stud"},{"issue":"1","key":"3474_CR50","doi-asserted-by":"crossref","first-page":"18965","DOI":"10.7448\/IAS.17.1.18965","volume":"17","author":"MH Kim","year":"2014","unstructured":"Kim MH, Mazenga AC, Devandra A, et al. Prevalence of depression and validation of the beck depression inventory-II and the children\u2019s depression inventory-short amongst HIV-positive adolescents in Malawi. J Int AIDS Soc. 2014;17(1):18965.","journal-title":"J Int AIDS Soc"},{"issue":"1","key":"3474_CR51","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1016\/j.jadohealth.2017.11.002","volume":"62","author":"N Kagotho","year":"2018","unstructured":"Kagotho N, Patak-Pietrafesa M, Ssewamala FM, Kirkbride G. Assessing the association between depression and savings for Kenyan youth using a validated child depression inventory measure. J Adolesc Health. 2018;62(1):S21-8.","journal-title":"J Adolesc Health"},{"issue":"1","key":"3474_CR52","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12887-016-0565-2","volume":"16","author":"A Binagwaho","year":"2016","unstructured":"Binagwaho A, Fawzi MCS, Agbonyitor M, et al. Validating the children\u2019s depression inventory in the context of Rwanda. BMC Pediatr. 2016;16(1):1\u20137.","journal-title":"BMC Pediatr"},{"issue":"1","key":"3474_CR53","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-020-10147-z","volume":"21","author":"Y Shenderovich","year":"2021","unstructured":"Shenderovich Y, Boyes M, DegliEsposti M, et al. Relationships with caregivers and mental health outcomes among adolescents living with HIV: a prospective cohort study in South Africa. BMC Public Health. 2021;21(1):1\u201311.","journal-title":"BMC Public Health"},{"issue":"8","key":"3474_CR54","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1111\/j.1469-7610.2007.01757.x","volume":"48","author":"L Cluver","year":"2007","unstructured":"Cluver L, Gardner F, Operario D. Psychological distress amongst AIDS-orphaned children in urban South Africa. J Child Psychol Psychiatry. 2007;48(8):755\u201363.","journal-title":"J Child Psychol Psychiatry"},{"issue":"1","key":"3474_CR55","first-page":"149","volume":"93","author":"L Sherr","year":"2014","unstructured":"Sherr L, Croome N, Clucas C, Brown E. Differential effects of single and double parental death on child emotional functioning and daily life in South Africa. Child Welfare. 2014;93(1):149.","journal-title":"Child Welfare"},{"issue":"1","key":"3474_CR56","doi-asserted-by":"crossref","first-page":"11","DOI":"10.2989\/17280583.2017.1283320","volume":"29","author":"N Woollett","year":"2017","unstructured":"Woollett N, Cluver L, Bandeira M, Brahmbhatt H. Identifying risks for mental health problems in HIV positive adolescents accessing HIV treatment in Johannesburg. J Child Adolesc Mental Health. 2017;29(1):11\u201326.","journal-title":"J Child Adolesc Mental Health"},{"issue":"2","key":"3474_CR57","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/BF00919131","volume":"6","author":"CR Reynolds","year":"1978","unstructured":"Reynolds CR, Richmond BO. What I think and feel: a revised measure of children\u2019s manifest anxiety. J Abnorm Child Psychol. 1978;6(2):271\u201380.","journal-title":"J Abnorm Child Psychol"},{"key":"3474_CR58","first-page":"323","volume-title":"The use of psychological testing for treatment planning and outcomes assessment","author":"AB Gerard","year":"1999","unstructured":"Gerard AB, Reynolds CR. Characteristics and applications of the revised children\u2019s manifest anxiety scale (RCMAS). In: Maruish ME, editor. The use of psychological testing for treatment planning and outcomes assessment. Mahwah: Lawrence Erlbaum Associates Publishers; 1999. p. 323\u201340."},{"issue":"2","key":"3474_CR59","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1027\/1015-5759\/a000134","volume":"29","author":"ME Boyes","year":"2013","unstructured":"Boyes ME, Cluver LD. Performance of the revised children\u2019s manifest anxiety scale in a sample of children and adolescents from poor urban communities in Cape Town. Eur J Psychol Assess. 2013;29(2):113\u201320.","journal-title":"Eur J Psychol Assess"},{"key":"3474_CR60","volume-title":"Child PTSD checklist","author":"L Amaya-Jackson","year":"1995","unstructured":"Amaya-Jackson L, McCarthy G, Cherney M, Newman E. Child PTSD checklist. Durham: Duke University Medical Center; 1995."},{"issue":"10","key":"3474_CR61","doi-asserted-by":"crossref","first-page":"e46905","DOI":"10.1371\/journal.pone.0046905","volume":"7","author":"ME Boyes","year":"2012","unstructured":"Boyes ME, Cluver LD, Gardner F. Psychometric properties of the child PTSD checklist in a community sample of South African children and adolescents. PLoS ONE. 2012;7(10):e46905.","journal-title":"PLoS ONE"},{"key":"3474_CR62","unstructured":"Newman E, Amaya-Jackson L. Assessment of trauma instruments for children. In: Paper presented at 12th international conference for traumatic stress studies. San Francisco, USA; 1996."},{"key":"3474_CR63","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and statistical manual of mental disorders DSM-5","author":"American Psychiatric Association","year":"2013","unstructured":"American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSM-5. Washington: American Psychiatric Association; 2013."},{"issue":"2","key":"3474_CR64","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1192\/bjp.184.2.169","volume":"184","author":"S Seedat","year":"2004","unstructured":"Seedat S, Nyamai C, Njenga F, Vythilingum B, Stein DJ. Trauma exposure and post-traumatic stress symptoms in urban African schools: survey in Cape Town and Nairobi. Br J Psychiatry. 2004;184(2):169\u201375.","journal-title":"Br J Psychiatry"},{"issue":"1","key":"3474_CR65","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1080\/16826108.2000.9632366","volume":"12","author":"S Seedat","year":"2000","unstructured":"Seedat S, Van Nood E, Vythilingum B, Stein DJ, Kamlner D. School survey of exposure to violence and posttraumatic stress symptoms in adolescents. South Afr J Child Adolesc Ment Health. 2000;12(1):38\u201344.","journal-title":"South Afr J Child Adolesc Ment Health"},{"issue":"3","key":"3474_CR66","doi-asserted-by":"crossref","first-page":"313","DOI":"10.4088\/JCP.09m05305whi","volume":"71","author":"DV Sheehan","year":"2010","unstructured":"Sheehan DV, Sheehan KH, Shytle RD, et al. Reliability and validity of the mini international neuropsychiatric interview for children and adolescents (MINI-KID). J Clin Psychiatry. 2010;71(3):313\u201326.","journal-title":"J Clin Psychiatry"},{"issue":"5","key":"3474_CR67","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/S0924-9338(97)83296-8","volume":"12","author":"Y Lecrubier","year":"1997","unstructured":"Lecrubier Y, Sheehan DV, Weiller E, et al. The mini international neuropsychiatric interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiatry. 1997;12(5):224\u201331.","journal-title":"Eur Psychiatry"},{"issue":"5","key":"3474_CR68","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/S0924-9338(97)83297-X","volume":"12","author":"D Sheehan","year":"1997","unstructured":"Sheehan D, Lecrubier Y, Sheehan KH, et al. The validity of the mini international neuropsychiatric interview (MINI) according to the SCID-P and its reliability. Eur Psychiatry. 1997;12(5):232\u201341.","journal-title":"Eur Psychiatry"},{"key":"3474_CR69","volume-title":"Release 15 [computer program]","author":"Stata Statistical Software","year":"2017","unstructured":"Stata Statistical Software. Release 15 [computer program]. Colllege Station: StataCorp LLC; 2017."},{"issue":"1","key":"3474_CR70","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1093\/oxfordjournals.aje.a115101","volume":"129","author":"RM Mickey","year":"1989","unstructured":"Mickey RM, Greenland S. The impact of confounder selection criteria on effect estimation. Am J Epidemiol. 1989;129(1):125\u201337.","journal-title":"Am J Epidemiol"},{"issue":"11","key":"3474_CR71","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1093\/oxfordjournals.aje.a116813","volume":"138","author":"G Maldonado","year":"1993","unstructured":"Maldonado G, Greenland S. Simulation study of confounder-selection strategies. Am J Epidemiol. 1993;138(11):923\u201336.","journal-title":"Am J Epidemiol"},{"key":"3474_CR72","doi-asserted-by":"publisher","DOI":"10.4236\/health.2013.53A086","author":"TJ Rochat","year":"2013","unstructured":"Rochat TJ, Bland RM, Tomlinson M, Stein A. Suicide ideation, depression and HIV among pregnant women in rural South Africa. Health. 2013. https:\/\/doi.org\/10.4236\/health.2013.53A086.","journal-title":"Health"},{"issue":"1","key":"3474_CR73","doi-asserted-by":"crossref","first-page":"20049","DOI":"10.7448\/IAS.18.1.20049","volume":"18","author":"OA Adejumo","year":"2015","unstructured":"Adejumo OA, Malee KM, Ryscavage P, Hunter SJ, Taiwo BO. Contemporary issues on the epidemiology and antiretroviral adherence of HIV-infected adolescents in sub-Saharan Africa: a narrative review. J Int AIDS Soc. 2015;18(1):20049.","journal-title":"J Int AIDS Soc"},{"issue":"1","key":"3474_CR74","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1093\/pch\/13.1.19","volume":"13","author":"D Taddeo","year":"2008","unstructured":"Taddeo D, Egedy M, Frappier J-Y. Adherence to treatment in adolescents. Paediatr Child Health. 2008;13(1):19\u201324.","journal-title":"Paediatr Child Health"},{"issue":"9","key":"3474_CR75","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1093\/abm\/kaaa005","volume":"54","author":"C Psaros","year":"2020","unstructured":"Psaros C, Smit JA, Mosery N, et al. PMTCT adherence in pregnant South African women: the role of depression, social support, stigma, and structural barriers to care. Ann Behav Med. 2020;54(9):626\u201336.","journal-title":"Ann Behav Med"},{"key":"3474_CR76","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12978-020-00913-y","volume":"17","author":"CA Laurenzi","year":"2020","unstructured":"Laurenzi CA, Gordon S, Abrahams N, et al. Psychosocial interventions targeting mental health in pregnant adolescents and adolescent parents: a systematic review. Reprod Health. 2020;17:1\u201315.","journal-title":"Reprod Health"},{"issue":"4","key":"3474_CR77","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.midw.2012.05.010","volume":"29","author":"F Alderdice","year":"2013","unstructured":"Alderdice F, McNeill J, Lynn F. A systematic review of systematic reviews of interventions to improve maternal mental health and well-being. Midwifery. 2013;29(4):389\u201399.","journal-title":"Midwifery"},{"issue":"9","key":"3474_CR78","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1080\/09540121003600352","volume":"22","author":"D Futterman","year":"2010","unstructured":"Futterman D, Shea J, Besser M, et al. Mamekhaya: a pilot study combining a cognitive-behavioral intervention and mentor mothers with PMTCT services in South Africa. AIDS Care. 2010;22(9):1093\u2013100.","journal-title":"AIDS Care"},{"issue":"6","key":"3474_CR79","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1080\/03630242.2011.606356","volume":"51","author":"JP Mundell","year":"2011","unstructured":"Mundell JP, Visser MJ, Makin JD, et al. The impact of structured support groups for pregnant South African women recently diagnosed HIV positive. Women Health. 2011;51(6):546\u201365.","journal-title":"Women Health"},{"issue":"1","key":"3474_CR80","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-015-0429-z","volume":"15","author":"LM Hill","year":"2015","unstructured":"Hill LM, Maman S, Groves AK, Moodley D. Social support among HIV-positive and HIV-negative adolescents in Umlazi, South Africa: changes in family and partner relationships during pregnancy and the postpartum period. BMC Pregnancy Childbirth. 2015;15(1):1\u20139.","journal-title":"BMC Pregnancy Childbirth"},{"issue":"11","key":"3474_CR81","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1080\/17441692.2020.1775867","volume":"15","author":"E Toska","year":"2020","unstructured":"Toska E, Laurenzi CA, Roberts KJ, Cluver L, Sherr L. Adolescent mothers affected by HIV and their children: a scoping review of evidence and experiences from sub-Saharan Africa. Glob Public Health. 2020;15(11):1655\u201373.","journal-title":"Glob Public Health"},{"issue":"1","key":"3474_CR82","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1080\/09540121.2018.1524121","volume":"31","author":"ME Boyes","year":"2019","unstructured":"Boyes ME, Cluver LD, Meinck F, Casale M, Newnham E. Mental health in South African adolescents living with HIV: correlates of internalising and externalising symptoms. AIDS Care. 2019;31(1):95\u2013104.","journal-title":"AIDS Care"},{"key":"3474_CR83","unstructured":"UNICEF. HIV\/AIDS Global and regional trends [Internet]. New York, USA; 2020 [cited 2021 Sept 1]. Available from: https:\/\/data.unicef.org\/topic\/hivaids\/global-regional-trends\/."},{"issue":"10157","key":"3474_CR84","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1016\/S0140-6736(18)31612-X","volume":"392","author":"V Patel","year":"2018","unstructured":"Patel V, Saxena S, Lund C, et al. The lancet commission on global mental health and sustainable development. Lancet. 2018;392(10157):1553\u201398.","journal-title":"Lancet"},{"issue":"9926","key":"3474_CR85","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1016\/S0140-6736(13)62382-X","volume":"383","author":"KS Jacob","year":"2014","unstructured":"Jacob KS, Patel V. Classification of mental disorders: a global mental health perspective. Lancet. 2014;383(9926):1433\u20135.","journal-title":"Lancet"},{"key":"3474_CR86","doi-asserted-by":"crossref","first-page":"e25556","DOI":"10.1002\/jia2.25556","volume":"23","author":"CA Laurenzi","year":"2020","unstructured":"Laurenzi CA, Skeen S, Gordon S, et al. Preventing mental health conditions in adolescents living with HIV: an urgent need for evidence. J Int AIDS Soc. 2020;23:e25556.","journal-title":"J Int AIDS Soc"}],"container-title":["AIDS and Behavior"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10461-021-03474-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10461-021-03474-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10461-021-03474-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T10:30:21Z","timestamp":1647945021000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10461-021-03474-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,27]]},"references-count":86,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["3474"],"URL":"https:\/\/doi.org\/10.1007\/s10461-021-03474-8","relation":{},"ISSN":["1090-7165","1573-3254"],"issn-type":[{"value":"1090-7165","type":"print"},{"value":"1573-3254","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,27]]},"assertion":[{"value":"16 September 2021","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 September 2021","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approvals for the study were obtained from the Universities of Oxford (SSD\/CUREC2\/12-21) and Cape Town (CSSR 2013\/14) as well as University College London for these analyses (14795\/001). Additional local approvals were obtained from the South African Provincial Departments of Education and Health as well as the ethics committees of participating clinics.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}]}}