Prevalence and determinants of depression among adolescents living with HIV attending teen clubs in Blantyre, Malawi

Depression is a major global public health concern. The World Health Organization estimates that approximately 322 million people worldwide, nearly 5% of the global population live with depression, making it one of the leading contributors to the global burden of disease. Adolescents Living with HIV (ALHIV) are particularly vulnerable to depression due to multiple environmental, social, and health-related stressors, including stigma, chronic illness management, and family dynamics. Despite these risks, limited evidence exists on the prevalence and determinants of depression among ALHIV in Malawi. This health facility-based cross-sectional study assessed the prevalence of depression and its associated determinants among ALHIV aged 10–20 years attending Teen Clubs in Blantyre District, Malawi. Five health facilities were randomly selected for the study: Chileka, Lirangwe, Mdeka, Lundu, and Limbe Health Centres. Depression was measured using the Kutcher Adolescent Depression Scale-11 (KADS-11), a validated screening tool for adolescent depression. A KADS score of ≥5 was used to classify participants as having depression, while scores below this threshold were categorized as normal. A total of 145 adolescents participated in the study, with a mean age of 14.3 years (SD = 2.7). Females constituted 51% (74/145) of the participants. The study found that the overall prevalence of depression among ALHIV was 52.4% (76/145), indicating a substantial mental health burden within this population. Logistic regression analysis identified several factors associated with depression. Frequent parental conflict was significantly associated with depression among participants (p = 0.002, 95% CI: β = 1.868, 0.684–4.009). Educational level was also significantly associated with depression, with lower levels of education (primary and secondary) showing significant negative associations (p = 0.002). Additionally, school attendance was found to be associated with higher odds of depression, with school-going adolescents showing significantly increased likelihood of experiencing depressive symptoms (p = 0.015). These findings highlight the urgent need to integrate mental health screening and psychosocial support services into HIV care programs targeting adolescents. The results provide important evidence that can inform policymakers, healthcare providers, and program implementers in developing targeted interventions to address depression among ALHIV. Strengthening mental health services within adolescent HIV programs may improve treatment adherence, quality of life, and long-term health outcomes for this vulnerable population.