AYWH in Uganda frequently missed clinic appointments regardless of pandemic phase, had high initial mental health symptoms that decreased over 6 months, and had sufficient mobile phone and internet access to support mHealth interventions for HIV care continuity.
Key Findings
Results
The cohort of adolescents and young adults with HIV had a mean age of 18.6 years and the majority achieved viral suppression.
86 participants were enrolled at Mbarara Regional Referral Hospital
Mean age was 18.6 years
51.2% were male
89.5% had a viral load of <400 copies/ml
Results
A high proportion of AYWH had depression at enrollment, with a mean anxiety/psychosocial distress score of 36.7.
53% of participants had depression at enrollment, using a CES-D score >15 as the threshold for significant depression
Mean anxiety/psychosocial distress score was 36.7 on a locally validated scale scored 0-100
Mental health was assessed at enrollment, three months, and six months
Results
Depression and anxiety/psychosocial distress scores decreased significantly over the 6-month follow-up period.
Depression decreased significantly over 6 months (β = -0.46; 95% CI -0.73, -0.19; p < 0.001)
Anxiety/psychosocial distress also decreased significantly (β = -1.25; 95% CI -1.65, -0.86; p = 0.001)
Mental health was evaluated using the CES-D scale and a locally validated anxiety/psychosocial distress scale
Results
AYWH missed a substantial proportion of clinic visits, with lower rates of missed ART pickup and laboratory visits.
AYWH missed 19.0% of clinic visits over the 24-month assessment period
3.2% of ART pickup visits were missed
5.1% of laboratory visits were missed
Missed visits were assessed using the timeline follow-back method over 24 months
There was no clear variation in missed visits by pandemic phase
Results
The majority of AYWH had access to mobile phones, with most phone owners having smartphones and daily internet access.
59% of AYWH had mobile phone access
Of those with mobile phones, 67% owned a smartphone
71% of mobile phone owners had daily internet access
Access to mobile phones, smartphones, and internet was assessed prospectively
Results
Care interruptions among AYWH occurred regardless of COVID-19 pandemic phase, suggesting structural and chronic factors rather than pandemic-specific causes.
The study design was retrospective and prospective, covering periods during and after the COVID-19 pandemic
There was 'no clear variation by pandemic phase' in missed visits
The study authors noted that care interruptions may occur due to structural barriers as well as comorbidities such as mental health issues
Adong J, Musinguzi N, Nansera D, Nayiga H, Kankunda A, Bebell L, et al.. (2026). HIV care interruptions, mental health, and the potential for mHealth interventions among adolescents and young adults with HIV in Uganda.. AIDS research and therapy. https://doi.org/10.1186/s12981-026-00853-w