'You Are Always Worried and Have No Peace, You Cannot Be a Normal Adolescent': A Qualitative Study of the Effects of Mental Health Problems on the Social Functioning of Adolescents Living with HIV in Uganda.

Adolescents living with HIV (ALHIV) are at heightened risk of experiencing mental health problems. However, research on the impact of mental health problems on ALHIV's everyday life is scanty. This article explores the effects of anxiety, depression and suicidal behaviour on the social functioning of ALHIV in a low-resource setting. The three mental health conditions were screened using the Patient Health Questionnaire modified for adolescents (PHQ-A) and Screen for Child Anxiety Related Disorder (SCARED), while social functioning was defined by normative role expectations of adolescents in the study setting. We conducted in-depth interviews with 31 ALHIV receiving care at two hospitals in Central Uganda. Data were analysed using thematic analysis techniques. We found that mental health problems impair the social functioning of ALHIV by obstructing them from realising normative expectations of adolescents within their socio-cultural milieu, including academic excellence, maintaining amicable relationships and good physical health. In a context of scarcity, impaired social functioning has grave implications for ALHIV's physical, psychological and social and economic wellbeing and concomitantly HIV treatment outcomes in the immediate and long term. Integration of mental health into HIV care is imperative, if the global goal to end AIDS is to be achieved.