Replication of a Longitudinal Study on the Mental Health Trajectories of HIV-Negative Adolescent Girls in Combination HIV Prevention Programmes in Soweto, South Africa

Combination HIV prevention programmes for adolescent girls and young women in high-prevalence settings are a key HIV reduction strategy. An original study indicated that enrolment was associated with improved mental health for HIV-negative participants, but the consistency of this effect required verification. This replication study aimed to re-examine the mental health trajectories of HIV-negative adolescent girls in combination HIV prevention programmes in Soweto, South Africa. The primary objective was to determine whether previously observed reductions in depression and anxiety symptoms could be reproduced. A longitudinal replication study was conducted with a new cohort of HIV-negative adolescent girls enrolled in a standard combination prevention programme. Validated measures assessed depression and anxiety at baseline and at two follow-up points. Analytical methods mirrored the original study, using mixed-effects models to track symptom trajectories. The replication did not reproduce the original findings of significant improvement. Mental health scores remained stable over time, with no statistically significant reduction in symptoms of depression or anxiety. A notable proportion of participants reported clinically significant depressive symptoms at the final assessment. The hypothesised mental health benefit of programme enrolment was not observed. This suggests psychological outcomes for HIV-negative adolescent girls in these programmes may be more complex and context-dependent than previously indicated. Future combination prevention programmes should integrate dedicated mental health support as a core component. Further research is needed to identify specific programme elements or external factors that moderate mental health outcomes. replication study, adolescent health, mental health, HIV prevention, depression, anxiety, South Africa This study provides a critical replication of prior research, offering evidence that anticipated mental health benefits from HIV prevention programmes are not assured and highlighting a need for integrated psychosocial support.