Psychosocial Assessment of Ghanaian Adolescent Living with HIV Using the HEADSSS Assessment Approach: A Mixed Methods Study

Abstract

Adolescents living with HIV (ALHIV) face the dilemmas of adolescence combined with complex issues regarding living with a chronic and stigmatizing conditions. This study aimed at identifying the psychosocial stressors of ALHIV in Ghana and how these predict their overall quality of life. METHODS: A mixed methods study was conducted among 98 ALHIV (80 and 18 respectively, for the quantitative and qualitative aspects), accessing antiretroviral therapy services at the Cape Coast Teaching Hospital, Ghana. Total sampling was used. Survey and in-depth interviews were used to satisfy the quantitative and qualitative demands, respectively. Both were guided by the HEADSSS psychosocial assessment tool- a structured clinical instrument that touches on the major areas of adolescent psychosocial stress and provides a useful screening profile. Quantitative data were analysed using the Stata version 13 software, while the qualitative data were analysed thematically using NVivo version 11. RESULTS: A total of 52 (53.1%) constituted the younger ALHIV group who were within the ages 10-14 years while 46 (46.9%) were older ALHIV between 15-19 years old. A majority of 48 (49.0%) had both parents alive while over a fifth (n=22, 22.5%) were total orphans. The study found a high psycho-social burden and a higher risk of mental health problems among ALHIV. Indicators for depression, as observed were mainly; unfavourable home situation, social isolation, body image disturbance and legitimate HIV diagnosis related fears such as stigma, dying young, and not being able to marry or have sexual relationships. Low level of sexual knowledge (29.9%) and the ability to negotiate the use of condom (14.3%), were also observed. CONCLUSION: Our study has generated evidence of a greater psychosocial burden among Ghanaian ALHIV, with an associated threat to their quality of life and survival. This warrants a prioritized need to strengthen their psychosocial care.