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Table 2 Factors associated with depression (CDRS-R score >55) (unadjusted and adjusted for sex and age)

From: Factors associated with depression among adolescents living with HIV in Malawi

 

Variable

Mean (SD, N)/N (%)

N (%)

Unadjusted OR (95 % CI)

Unadjusted p-value (overall)

Adjusted OR (95 % CI)

Adjusted p-value (overall)

Socio-demographic factors

School Grade

 

Not in school/Junior Primary School

176 (31.3)

35 (19.9)

1.45 [0.81-2.57]

0.27

2.82 [1.39-5.73]

0.009

 

Senior Primary School

229 (40.7)

48 (21)

1.54 [0.90-2.66]

2.36 [1.29-4.32]

 

Secondary School or Tertiary

157 (27.9)

23 (14.6)

Reference

Reference

Family’s estimated combined income

 

Less than 14,000 MK per month

171 (31.8)

36 (21.1)

1.32 [0.77-2.25]

0.24

1.33 [0.77-2.28]

0.23

 

14,000 -49,999 MK per month

117 (21.8)

16 (13.7)

0.78 [0.40-1.51]

0.79 [0.41-1.54]

 

More than 50,000 per month

71 (13.2)

17 (23.9)

1.55 [0.79-3.04]

1.61 [0.82-3.16]

 

I do not know

178 (33.1)

30 (16.9)

Reference

Reference

Location of home

 

In the city

369 (65.7)

67 (18.2)

0.83 [0.48-1.45]

0.81

0.78 [0.45-1.36]

0.69

 

Just outside the city

93 (16.5)

18 (19.4)

0.9 [0.45-1.83]

0.81 [0.40-1.65]

 

Rural area

100 (17.8)

21 (21)

Reference

Reference

Time it take to get to the clinic from home

 

0-30minutes

71 (12.7)

14 (19.7)

1.25 [0.64-2.43]

0.38

1.22 [0.62-2.40]

0.50

 

31-60 minutes

229 (40.8)

49 (21.4)

1.38 [0.88-2.17]

1.31 [0.83-2.08]

 

>60 minutes

261 (46.5)

43 (16.5)

Reference

Reference

Primary caregiver type

 

Father/Mother

178 (31.7)

33 (18.5)

0.64 [0.38-1.10]

0.04

0.68 [0.39-1.17]

0.07

 

Both parents

112 (19.9)

13 (11.6)

0.37 [0.19-0.74]

0.4 [0.20-0.81]

 

Uncle/Aunt

138 (24.6)

25 (18.1)

0.63 [0.35-1.12]

0.64 [0.36-1.15]

 

Other/Grandparent

134 (23.8)

35 (26.1)

Reference

Reference

Past-traumatic events/stressors

Maternal death or employment status

 

Not working

106 (18.9)

19 (17.9)

0.77 [0.43-1.36]

0.21

0.8 [0.45-1.43]

0.31

 

Self-employed

103 (18.3)

14 (13.6)

0.55 [0.29-1.04]

0.58 [0.30-1.09]

 

Employed by someone else

73 (13)

11 (15.1)

0.62 [0.31-1.26]

0.67 [0.33-1.36]

 

Died

280 (49.8)

62 (22.1)

Reference

Reference

Change in caregiver

 

No change in caregiver

422 (75.2)

70 (16.6)

0.57 [0.36-0.90]

0.02

0.57 [0.36-0.90]

0.02

 

Caregiver has changed once or more

139 (24.8)

36 (25.9)

Reference

 

Reference

 

Experience of family/household deaths

 

Nobody in my family has died

149 (26.5)

22 (14.8)

0.68 [0.41-1.13]

0.14

0.67 [0.40-1.12]

0.12

 

One or more people have died

413 (73.5)

84 (20.3)

Reference

Reference

Failed school term/class

 

No

327 (58.9)

55 (16.8)

0.78 [0.51-1.20]

0.26

0.76 [0.49-1.17]

0.21

 

Yes

228 (41.1)

47 (20.6)

Reference

Reference

Experience of forced sex, physical abuse, or witnessed physical violence in the home

 

No

477 (84.9)

79 (16.6)

0.43 [0.25-0.71]

0.001

0.45 [0.26-0.76]

0.003

 

Yes

85 (15.1)

27 (31.8)

Reference

Reference

Experience of being bullied for one’s physical appearance

 

No

427 (76.1)

70 (16.4)

0.53 [0.34-0.85]

0.008

0.58 [0.36-0.93]

0.02

 

Yes

134 (23.9)

36 (26.9)

Reference

Reference

Experience of being bullied for taking medicines

 

No

459 (88.4)

73 (15.9)

0.23 [0.13-0.41]

<0.0001

0.27 [0.15-0.48]

<0.0001

 

Yes

60 (11.6)

27 (45)

Reference

Reference

 

Hospital admissions in the past year

 

No

510 (90.7)

92 (18)

0.6 [0.31-1.15]

0.12

0.58 [0.30-1.13]

0.11

 

Yes

52 (9.3)

14 (26.9)

Reference

Reference

Behavioral factors/social support

Past history of being in a romantic relationship that did not involve sex

 

Never had a boyfriend/girlfriend

479 (85.4)

83 (17.3)

0.54 [0.31-0.92]

0.02

0.65 [0.36-1.18]

0.16

 

Yes, in the past or current

82 (14.6)

23 (28)

Reference

Reference

Satisfaction with the way I look (physical appearance)

 

I am very happy with the way I look

460 (82)

77 (16.7)

0.5 [0.30-0.82]

0.006

0.54 [0.33-0.89]

0.02

 

I am somewhat/ not at all satisfied with the way I look

101 (18)

29 (28.7)

Reference

Reference

Use of alcohol in the past 30 days

 

Never

547 (97.3)

100 (18.3)

0.34 [0.12-0.96]

0.04

0.37 [0.13-1.07]

0.07

 

Once a month or more

15 (2.7)

6 (40)

Reference

Reference

HIV disclosure status*

 

Disclosed and have shared with someone

273 (48.6)

51 (18.7)

1.19 [0.65-2.17]

0.64

0.90 [0.47-1.75]

0.54

 

Disclosed, have not shared with anyone

184 (32.7)

38 (20.7)

1.35 [0.72-2.53]

1.19 [0.62-2.28]

 

Not disclosed

105 (18.7)

17 (16.2)

Reference

Reference

 

Age at disclosure

12.3 (1.6, 4.6)

 

1.27 [1.11-1.47]

0.0008

1.31 [1.11-1.56]

0.002

Bio-clinical parameters

 

Child on ART

 

No

36 (6.4)

4 (11.1)

0.52 [0.18-1.50]

0.23

0.54 [0.18-1.56]

0.25

 

Yes

526 (93.6)

102 (19.4)

Reference

Reference

Efavirenz based ART regimen

 

No

526 (93.6)

103 (19.6)

2.68 [0.81-8.90]

0.11

2.75 [0.82-9.19]

0.10

 

Yes

36 (6.4)

3 (8.3)

Reference

Reference

Second line ART regimen

 

No

491 (87.4)

94 (19.1)

1.16 [0.60-2.25]

0.65

1.18 [0.60-2.31]

0.63

 

Yes

71 (12.6)

12 (16.9)

Reference

Reference

History of TB treatment

 

No

309 (55)

61 (19.7)

1.14 [0.74-1.74]

0.56

1.13 [0.74-1.75]

0.56

 

Yes

253 (45)

45 (17.8)

Reference

Reference

Initial WHO stage

 

WHO stage 1-2

160 (28.7)

28 (17.5)

0.88 [0.55-1.43]

0.61

0.91 [0.56-1.47]

0.71

 

WHO Stage 3-4

398 (71.3)

77 (19.3)

Reference

Reference

 

Most recent CD4 count

516 (307, 509)

 

1 [1.00-1.00]

0.08

1 [1.00-1.00]

0.12

HIV immunological classification

 

None or not significant

235 (46.2)

32 (13.6)

0.58 [0.31-1.08]

0.04

0.6 [0.32-1.13]

0.05

 

Mild

112 (22)

15 (13.4)

0.57 [0.27-1.19]

0.57 [0.27-1.19]

 

Advanced

68 (13.4)

18 (26.5)

1.33 [0.64-2.77]

1.35 [0.64-2.82]

 

Severe

94 (18.5)

20 (21.3)

Reference

Reference

Current nutritional status

 

Normal

544 (96.8)

100 (18.4)

0.45 [0.17-1.23]

0.12

0.38 [0.13-1.05]

0.06

 

Malnourished

18 (3.2)

6 (33.3)

Reference

Reference

 

BMI for age z-score

−0.88 (1.18, 561)

 

0.96 [0.80-1.14]

0.61

0.89 [0.74-1.08]

0.24

 

Height for age z-score

−1.79 (1.16, 561)

 

0.93 [0.78-1.12]

0.46

0.87 [0.72-1.06]

0.17