Globally, mental health problems have been reported to be more common in youth living with
HIV (YLWH) than in the general population, but routine mental health screening is rarely done in
high-volume HIV clinics. In 2019, YLWH in a large HIV clinic in Botswana were screened using
the Generalized Anxiety Scale-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) in a pilot
standard-of-care screening programme. Two-way ANOVA was used to describe the effects of age
group (12–<16, 16–<20 and 20–25 years old) and sex on GAD-7 and PHQ-9 scores. Chi-square
statistics were used to compare characteristics of YLWH with and without potential suicidality/
self-harm symptoms based on question 9 in the PHQ-9. Among 1 469 YLWH, 33.1%, 44.3% and
15.0% had anxiety, depression and potential suicidality/self-harm symptoms respectively. YLWH
of 20–25 years old and 16–<20 years old had higher GAD-7 scores compared to 12–<16-year-olds
(
p = 0.014 and
p = <0.001 respectively). Female YLWH of 20–25 years old had higher PHQ-9
scores compared to 12–<16-year-olds (
p = 0.002). There were no other sex–age dynamics thatwere statistically significant. Female YLWH endorsed more thoughts of suicidality/self-harm than
males (17% versus 13%,
p = 0.03 respectively). Given the proportion of YLWH with mental
health symptoms, Botswana should enhance investments in mental health services for YLWH,
especially for young female adults who bear a disproportionate burden.
Keywords
adolescents and youth persons with HIV; symptoms of mental health disorders; resource-limited
settings

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