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Table 1 Psychosocial characteristics evaluated using HEADSS framework

From: Understanding mental health difficulties and associated psychosocial outcomes in adolescents in the HIV clinic at Kenyatta National Hospital, Kenya

1. Socio-demographic characteristics—age, sex, education level, relation to the caregiver

2. Home environment—relationships with other household members, changing homes in the last 1 year, missing meals, and physical violence

3. Education—school performance, bullying, repeating classes, inability to pay school fees, change of schools in the last 2 years, and reasons for missing school

4. Activity and routine—involvement in extracurricular activities and religious activities

5. Drugs—use of drugs and substances of abuse

6. Sex—involvement in sexual activity, practice of safe sex, and worry about pregnancy/sexually transmitted diseases. Questions on sexual activity were restricted to adolescents aged 12 years and above

7. Suicide and depression—Any adolescent with a score of 1 or more on PHQ-9 was considered to have a depressive symptom

8. Adherence to ARV drugs—any positive response on any of the following 5 questions—do you ever refuse or miss drugs, don’t take drugs in front of others, or have problems taking drugs daily or on time—was taken to be an indication of non-adherence

9. Full disclosure of HIV status—an adolescent was classified as having full disclosure if they listed HIV in responding to any of the following 3 questions—why are you visiting the clinic, due to which illness, and why are you taking medication?