Childhood Maltreatment and Psychological Distress Among Adolescents and Young Adults Living with HIV in Zimbabwe.

Childhood maltreatment is one of the global public health crises that contributes to increased risk of developing mental health problems for young people living with HIV in resource-constrained settings. This study examines the association between childhood maltreatment and psychological distress among adolescents and young adults living with HIV (AYALWHIV) in Zimbabwe. This national cross-sectional survey used data from the 2017 Zimbabwe Violence Against Children Survey (N = 249 AYALWHIV). Four logistic regression models were performed to determine significant associations between childhood maltreatment and psychological distress as measured by Kessler 6 scale during the past 30 days. The findings indicated that AYALWHIV who experienced cumulative childhood maltreatment (58.8%; AOR = 3.43 [CI = 1.83-6.41]), including emotional abuse (69.7%; AOR = 3.43, CI = 1.83-6.41) and sexual abuse (58.8%; AOR = 2.97 CI = 1.05-8.41) were associated with higher odds of reporting moderate-to-severe psychological distress during the past 30 days after adjusting for other factors. Therefore, this study underscores the need for comprehensive interventions that prioritize tailored anti-stigma education, HIV prevention support groups, community violence prevention strategies, expanded access to mental health counseling services, and promotion of acceptance and empathetic environments for AYALWHIV in resource-constrained settings. Furthermore, integrating mental health and violence prevention services into HIV care through targeted policy initiatives is critical for building coordinated and sustainable support systems in communities where AYALWHIV lives in Zimbabwe.