Behavioral health risks in perinatally HIV-exposed youth: co-occurrence of sexual and drug use behavior, mental health problems, and nonadherence to antiretroviral treatment
Claude A Mellins, Katherine Tassiopoulos, Kathleen Malee, Anna-Barbara Moscicki, Doyle Patton, Renee Smith, Ann Usitalo, Susannah M Allison, Russell Van Dyke, George R Seage 3rd, Pediatric HIV/AIDS Cohort Study, Russell Van Dyke, Kenneth Rich, Suzanne Siminski, Mercy Swatson, William Shearer, Norma Cooper, Lynette Harris, Murli Purswani, Mahboobullah Baig, Anna Cintron, Ana Puga, Sandra Navarro, Doyle Patton, Sandra Burchett, Nancy Karthas, Betsy Kammerer, Ram Yogev, Kathleen Malee, Scott Hunter, Eric Cagwin, Andrew Wiznia, Marlene Burey, Molly Noycze, Janet Chen, Elizabeth Gobs, Mitzie Grant, Katherine Knapp, Kim Allison, Patricia Garvie, Midnela Acevedo-Flores, Heida Rios, Vivian Olivera, Margarita Silio, Cheryl Borne, Patricia Sirois, Stephen Spector, Kim Norris, Sharon Nichols, Elizabeth McFarland, Emily Barr, Robin McEvoy, Douglas Watson, Nicole Messenger, Rose Belanger, Arry Dieudonne, Linda Bettica, Susan Adubato, Lisa Himic, Elizabeth Willen, Claude A Mellins, Katherine Tassiopoulos, Kathleen Malee, Anna-Barbara Moscicki, Doyle Patton, Renee Smith, Ann Usitalo, Susannah M Allison, Russell Van Dyke, George R Seage 3rd, Pediatric HIV/AIDS Cohort Study, Russell Van Dyke, Kenneth Rich, Suzanne Siminski, Mercy Swatson, William Shearer, Norma Cooper, Lynette Harris, Murli Purswani, Mahboobullah Baig, Anna Cintron, Ana Puga, Sandra Navarro, Doyle Patton, Sandra Burchett, Nancy Karthas, Betsy Kammerer, Ram Yogev, Kathleen Malee, Scott Hunter, Eric Cagwin, Andrew Wiznia, Marlene Burey, Molly Noycze, Janet Chen, Elizabeth Gobs, Mitzie Grant, Katherine Knapp, Kim Allison, Patricia Garvie, Midnela Acevedo-Flores, Heida Rios, Vivian Olivera, Margarita Silio, Cheryl Borne, Patricia Sirois, Stephen Spector, Kim Norris, Sharon Nichols, Elizabeth McFarland, Emily Barr, Robin McEvoy, Douglas Watson, Nicole Messenger, Rose Belanger, Arry Dieudonne, Linda Bettica, Susan Adubato, Lisa Himic, Elizabeth Willen
Abstract
In a sample of perinatally HIV-infected (PHIV+) and perinatally HIV-exposed, uninfected (PHEU) adolescents, we examined the co-occurrence of behavioral health risks including mental health problems, onset of sexual and drug use behaviors, and (in PHIV+ youth) nonadherence to antiretroviral therapy (ART). Participants, recruited from 2007 to 2010, included 349 youth, ages 10-16 years, enrolled in a cohort study examining the impact of HIV infection and ART. Measures of the above behavioral health risks were administered to participants and primary caregivers. Nearly half the participants met study criteria for at least one behavioral health risk, most frequently, mental health problems (28%), with the onset of sexual activity and substance use each reported by an average of 16%. Among the sexually active, 65% of PHIV+ and 50% of PHEU youth reported unprotected sex. For PHIV +youth, 34% reported recent ART nonadherence, of whom 45% had detectable HIV RNA levels. Between 16% (PHIV+) and 11% (PHEU) of youth reported at least two behavioral health risks. Older age, but not HIV status, was associated with having two or more behavioral health risks versus none. Among PHIV+ youth, living with a birth mother (versus other caregivers) and detectable viral load were associated with co-occurrence of behavioral health risks. In conclusion, this study suggests that for both PHIV+ and PHEU youth, there are multiple behavioral health risks, particularly mental health problems, which should be targeted by service systems that can integrate prevention and treatment efforts.
Source: PubMed