The pattern and predictors of mental health service use among HIV positive children and adolescents

Abstract

BACKGROUND: Psychiatric manifestations of pediatric HIV infection have been described mainly in adolescent populations in Uganda. However, data on the nature of mental health services used by the pediatric HIV-infected population has not been reported in the Ugandan context. OBJECTIVE: To investigate the patterns and predictors of mental health service use among HIV infected children and adolescents attending MildmayUganda HIV treatment program. METHODS: This was a case-control study atMildmayUganda, an HIV treatment center in Uganda. HIV +vechildren who have ever used any form of mental health service (cases) reported their mental health providers, and were compared with HIV+ve children and adolescents without history of any form of mental health service use (controls). A variety of factors that could predict mental health service use among HIV infected children were assessed using a socio-demographic questionnaire, Child Behavior Checklist (CBCL), Child Depression Inventory (CDI)andthe Parent-Child Relationship Scale. Generated data were analyzed using STATA version 12.0. RESULTS:134 cases and 137 controls were recruited. Majority of the cases visited a religious leader 49.3 %, 34.3% sought treatment from a traditional healer. Those seen bya psychiatrist,counselor, psychologist, general practitioner and social worker were 37.3%, 47.8%, 5.2%, 11.2%, and 2.2%, respectively. Factors independently associated with mental health service use included; aggressivebehavior (p=0.01), attention problems p=<0.0001),withdrawn/depressive symptoms (p=0.004),child exposure to family death(p=0.035),high parental–child relationship total scores (p=<0.0001),high education level (=0.002) and recurrent respiratory tract infectionsp=<0.0001). CONCLUSIONS: There is concurrent use of alternative sources of mental health services by members of the community, even in areas psychiatric services are available.Behavioral problems, child exposure to death, respiratory tract infections were among factors associated with mental health service use.