Journal of Reproductive Health, Gender, and HIV in Africa | 18 October 2011
Mental Health Trajectories of HIV-Negative Adolescent Girls in a Combination HIV Prevention Programme: A Mixed Methods Longitudinal Analysis in Kisumu, Kenya
C, a, r, l, y, C, o, o, p, e, r, ,, W, a, n, j, i, k, u, M, w, a, n, g, i, ,, J, o, d, i, e, O, l, i, v, e, r
Abstract
Adolescent girls in sub-Saharan Africa are at high risk of HIV acquisition and experience a significant burden of common mental disorders. The longitudinal impact of combination HIV prevention programmes on the mental health of HIV-negative adolescent girls is not well documented. This study aimed to analyse the mental health trajectories of HIV-negative adolescent girls enrolled in a combination HIV prevention programme in Kisumu, Kenya, and to explore contextual factors influencing these trajectories. A concurrent mixed methods longitudinal design was employed. Depressive and anxiety symptoms were measured quantitatively using validated scales at three time points with a cohort of 350 participants. In-depth interviews were conducted qualitatively with a purposively sampled subset of 30 girls at each wave to explore lived experiences and perceived drivers of mental health change. Quantitative analysis revealed a non-linear trajectory, with a significant reduction in depressive symptom scores at the second assessment, followed by a slight increase at the third. Qualitative data indicated initial improvements were linked to programme-supported social cohesion and economic hope. Later challenges were associated with enduring structural vulnerabilities, including financial insecurity and gender-based violence. The mental health of adolescent girls in this prevention programme showed initial improvement but was not sustained. Mental health outcomes are dynamically influenced by both programme participation and broader socio-structural factors. HIV prevention programmes for adolescent girls should integrate robust, sustained mental health support. Interventions must concurrently address underlying structural drivers, such as economic vulnerability, to achieve lasting mental health benefits. adolescent health, mental health, HIV prevention, sub-Saharan Africa, mixed methods, longitudinal study, gender This study provides longitudinal evidence on the mental health trajectories of HIV-negative adolescent girls within a real-world prevention programme, highlighting the need for integrated mental health and structural interventions.