Resilience in Tanzanian Youth Living with HIV: A Longitudinal Exploration of Protective Factors and Challenges

Abstract

Background: Adolescence is a critical risk period for the onset of mental health difficulties. Youth living with HIV (YLWH) face additional challenges navigating peer and romantic relationships due to stigma and disclosure, putting youth more at risk for mental health difficulties. This study explored changes in resilience of youth enrolled in a mental health intervention by examining development protective factors to address challenges over a six-year period. Methods: YLWH in Moshi, Tanzania were recruited who enrolled in a mental health intervention, Sauti ya Vijana (SYV) and participated in an in-depth interview as a part of a prior needs assessment study, both of which also included demographic, mental health measures, and stigma measures. The first in-depth interview took place in 2013/2014; which was paired with a subsequent interview in 2020. Both interviews explored youth experiences with mental health, protective factors, and challenges. Resilience in respondents was defined as positive adaptations made in response to challenges. Results: Five youth completed in-depth interviews. Three participants were male; mean age of was 23.4 years (SD 0.9 years). PHQ9, SDQ, and UCLA scores decreased a average of 5.8 (SD 5.9), 9.4 (SD 5.7), and 6.0 points (SD 10.0), respectively; Berger stigma scores increased an average of 4.6 points (SD 5.4). The primary challenge youth described was stigma; the primary protective factor for resilience and mental health was social support. Conclusions: YLWH face many challenges; however, protective factors improved youth resilience to face these challenges. Youth need consistent support and resources as they transition into adulthood.