Depression and Sexual Trauma Among Adolescent Girls and Young Women in HIV-Prevention Research in Tanzania

• Published in: Maternal and child health journal Vol. 24; no. 5; pp. 620 - 629
• Main Authors: Cherenack, Emily M., Tolley, Elizabeth E., Kaaya, Sylvia, Headley, Jennifer, Baumgartner, Joy Noel
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.05.2020; Springer; Springer Nature B.V
• Subjects: Adolescent; Adolescents; Children & youth; Childrens health; Clinical outcomes; Clinical trials; Consent; Cross-Sectional Studies; Depression - epidemiology; Depression, Mental; Ethics; Female; Girls; Gynecology; Health aspects; Health Surveys; HIV; HIV Infections - prevention & control; Human immunodeficiency virus; Human subjects; Humans; Maternal & child health; Maternal and Child Health; Medicine; Medicine & Public Health; Mental depression; Mental health; Patient compliance; Pediatrics; Population Economics; Prevention; Psychological aspects; Public Health; Researchers; Risk factors; Self destructive behavior; Sex Offenses - psychology; Sex Offenses - statistics & numerical data; Sexual abuse; Sexual assault; Sexual Behavior; Sexually transmitted diseases; Social aspects; Sociology; Statistics; STD; Suicide; Suicides & suicide attempts; Tanzania - epidemiology; Teenage girls; Teenagers; Trauma; Young Adult; Tanzania; Africa; Clinical trials; Depression; HIV; Sexual trauma; Mental health; Tanzania
• ISSN: 1092-7875; 1573-6628; 1573-6628
• DOI: 10.1007/s10995-020-02888-5

Purpose Clinical trials are necessary to test HIV-prevention strategies among adolescent girls and young women in sub-Saharan Africa. Psychosocial risk factors that increase girls’ and young women’s vulnerability for HIV may also impact their experiences in clinical trials. A better understanding of psychosocial risks among girls and young women enrolled in HIV-prevention research is needed. This analysis explores depression and sexual trauma among adolescent girls and young women enrolled in a mock microbicide trial in Tanzania. Methods We collected cross-sectional data from 135 HIV-negative adolescent girls and young women between 15 and 21 in Dar es Salaam, Tanzania enrolled in a mock microbicide trial. Depression, sexual behavior, and sexual trauma were measured. Sexual trauma and demographic variables were entered into a multivariate binomial logistic regression model predicting depression. Findings Overall, 27% of participants had moderate-to-severe depression. The most commonly endorsed items were anhedonia (lack of interest/pleasure) and low mood, which were reported by 78% of participants. Thoughts of suicide or self-harm were endorsed by 17% of participants. Coerced/forced first sex was reported by 42% of participants. Participants reporting coerced/forced first sex had 3.16 times the likelihood of moderate-to-severe depression. Conclusions Depression and coerced/forced sex were common among participants in an HIV-prevention mock clinical trial in Tanzania. When enrolling adolescent girls and young women in HIV-prevention trials in sub-Saharan Africa, our research suggests the need for a trauma-informed approach, referrals for trauma and depression, and interventions that address the impact of depression and trauma on HIV prevention, clinical trial adherence, and clinical outcomes.