Prevalence and Factors Associated with Emotional Problems Among HIV-Positive Children and Adolescents with Viral Non-Suppression in Rural Northern Uganda.

Introduction: Children and adolescents living with HIV(CALWH) face significant mental health challenges, such as depression and anxiety, which negatively impact their HIV treatment outcomes. This study investigated the prevalence and factors associated with emotional problems among children and adolescents with unsuppressed viral loads in Northern Uganda. Methods: In 2021, 121 dyads of caregivers and CALWH (10 to 18 years) with unsuppressed viral loads were recruited from five community-based HIV clinics in Kitgum district. They were assessed for emotional problems using the Revised Child Anxiety and Depression Scale (RCADS-25), the Patterson Suicide Risk Assessment Tool and the Clinician-administered Post-traumatic Stress Disorder Scale for Children and Adolescents (CAPS-CA). Bivariate and multivariate analysis of the data was carried out using STATA version 18. Results: Emotional problems were observed in 61.97% of participants. Among these, depression was present in 45.45% of individuals, and all participants diagnosed with depression also exhibited significant comorbid anxiety symptoms. Notably, 16.52% of participants experienced anxiety without comorbid depression. Factors independently associated with emotional problems included food insecurity (p = 0.003; OR = 0.03), post-traumatic stress disorder (PTSD) (p < 0.0001; OR = 1.33), and high transportation costs to health facilities (p = 0.0069; OR = 1.00). However, no significant association was observed between emotional problems and gender (p = 0.94; χ² = 0.009). Conclusion : These results emphasize the importance of addressing underlying socio-economic and psychological factors to improve emotional well-being. Targeted interventions focused on reducing barriers to resources and providing mental health support are essential for fostering equitable mental health outcomes.