Impact of adverse childhood experiences on mental health challenges and suicidal thoughts among adolescents living with HIV: a multi-center study in Vietnam

Adolescents living with HIV (ALHIV) face considerable mental health challenges, frequently worsened by adverse childhood experiences (ACEs). Our study evaluated the prevalence of psychological disorders and their associations with ACEs among ALHIV in Ho Chi Minh City, Vietnam. A multi-center study was conducted from January to April 2022 among 349 adolescents, aged 12-18. Adverse Childhood Experience Scale and the Depression Anxiety Stress Scale-21 were used, along with self-reported suicidal thoughts. The prevalence of stress, anxiety, depression, and suicidal thoughts was 24.4%, 37.5%, 27.2%, and 11.8%, respectively. Nearly 86% of adolescents reported at least one ACE, and 60% experienced multiple ACEs. Violence and abuse were strongly associated with stress, depression, and suicidality. Suicidal thoughts were strongly predicted by physical abuse (aOR = 9.13), household mental illness (aOR = 8.28), and sexual abuse (aOR = 6.76). A dose-response association was observed: adolescents exposed to ≥4 ACEs had significantly higher odds of stress (aOR = 3.70), depression (aOR = 6.32), and suicidal thoughts (aOR = 18.06). ALHIV in Ho Chi Minh City experience a substantial burden of psychological distress, strongly associated with cumulative ACEs. Integrating mental health screening and trauma-informed interventions into routine HIV care is urgently needed to reduce these burdens.