Psychiatric Disorders, Antiretroviral Medication Adherence and Viremia in a Cohort of Perinatally HIV-Infected Adolescents and Young Adults

Bucek, Amelia; Leu, Cheng-Shiun; Benson, Stephanie; Warne, Patricia; Abrams, Elaine J.; Elkington, Katherine S.; Dolezal, Curtis; Wiznia, Andrew; Mellins, Claude A.

doi:10.1097/inf.0000000000001866

Cited by 41 publications

(30 citation statements)

References 36 publications

(41 reference statements)

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“…48 Early identification of these youth is critical for preventing the development of serious MH conditions, which may precipitate high-risk behaviors, including substance abuse and condomless sex leading to HIV transmission, as well as nonadherence to HIV treatment regimens and care for youth with PHIV. [49][50][51][52] Our data support the provision of multi-level, evidenceinformed prevention and interventions that appreciate the dynamic nature of adolescence and recognize both individual and family risk factors as key targets for prevention/intervention services. Although some community and structural stressors are not easily modified, they must be recognized and preempted through mental healthcare, recognition and de- a Adjusted OR of MH disorder for participant with a specific characteristic compared to the reference group.…”

Section: Mental Health In Us Youth With Hivsupporting

confidence: 54%

Mental Health Diagnoses, Symptoms, and Service Utilization in US Youth with Perinatal HIV Infection or HIV Exposure

Smith

Huo

Tassiopoulos

et al. 2019

AIDS Patient Care and STDs

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Youth perinatally HIV infected (PHIV) or HIV exposed, but uninfected (PHEU), are aging into adolescence and adulthood with multiple complex risk factors for mental health (MH) problems and poor MH treatment utilization. Our aims were to estimate prevalence of MH diagnoses, clinically significant symptoms, and MH treatment utilization among youth with PHIV and among PHEU youth, 10-22 years old. We also aimed to identify correlates of diagnoses and treatment utilization. Analyses of data from standardized interviews, behavioral assessments, and chart review of 551 youth revealed that 36% had a previous or current MH diagnosis, with no significant HIV status group differences. Prevalence of clinically significant symptoms was 15% for both groups, of whom a third had no diagnosis, and half were not receiving treatment. Among youth with a current MH diagnosis, those with PHIV had greater utilization of services than PHEU youth (67% vs. 51%; p = 0.04). Factors associated with MH diagnoses and/or treatment utilization included caregiver characteristics, age and sex of child, HIV status, and stressful life events. Prevalence of MH diagnoses was higher than in the general population, but lower than in similar perinatally HIV-exposed cohorts, with some unmet service needs, particularly in PHEU youth. Family characteristics warrant careful consideration in early diagnosis and treatment of MH problems among youth affected by HIV.

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Section: Mental Health In Us Youth With Hivsupporting

confidence: 54%

Mental Health Diagnoses, Symptoms, and Service Utilization in US Youth with Perinatal HIV Infection or HIV Exposure

Smith

Huo

Tassiopoulos

et al. 2019

AIDS Patient Care and STDs

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“…Another large review and meta-analysis that synthesized 125 studies with a total of 19 016 patients across 38 countries found that self-reported depression and alcohol and other substance misuse were among the top 15 barriers to adherence, along with other reasons such as forgetting, being busy, a change in routine, and the experience of medication side effects [76]. In perinatally infected youth, for whom nonadherence to treatment across health conditions is a significant issue [77], a range of psychiatric disorders, not just mood disorders, have been associated with nonadherence to HIV treatment and elevated viremia [78].…”

Section: Mental Health Impairment and Outcomes Along The Hiv Care Casmentioning

confidence: 99%

Mental health and HIV/AIDS

Remien

Stirratt

Nguyen

et al. 2019

Aids

428

211

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Tremendous biomedical advancements in HIV prevention and treatment have led to aspirational efforts to end the HIV epidemic. However, this goal will not be achieved without addressing the significant mental health and substance use problems among people living with HIV (PLWH) and people vulnerable to acquiring HIV. These problems exacerbate the many social and economic barriers to accessing adequate and sustained healthcare, and are among the most challenging barriers to achieving the end of the HIV epidemic. Rates of mental health problems are higher among both people vulnerable to acquiring HIV and PLWH, compared with the general population. Mental health impairments increase risk for HIV acquisition and for negative health outcomes among PLWH at each step in the HIV care continuum. We have the necessary screening tools and efficacious treatments to treat mental health problems among people living with and at risk for HIV. However, we need to prioritize mental health treatment with appropriate resources to address the current mental health screening and treatment gaps. Integration of mental health screening and care into all HIV testing and treatment settings would not only strengthen HIV prevention and care outcomes, but it would additionally improve global access to mental healthcare.

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“…In the United States, anxiety and depression are among the most common mental health disorders for adolescents and young adults [34]. For HIV-positive youth, anxiety and depression have been associated with poorer medication adherence and decreased viral suppression [35-40]. Furthermore, direct and indirect relationships between depression and anxiety and increased sexual risk behaviors among youth have been identified in several studies [41], though other studies have found null or conflicting findings.…”

Section: Resultsmentioning

confidence: 99%

Adolescent Medicine Trials Network for HIV/AIDS Interventions Data Harmonization: Rationale and Development of Guidelines

McCumber¹,

Cain²,

LeGrand³

et al. 2018

JMIR Res Protoc

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BackgroundThe Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) research program aims to defeat the rising HIV epidemic among adolescents and young adults in the United States.ObjectiveThis study aims to optimize cross-study analyses and comparisons of standardized measures (variables) collected in the ATN.MethodsGuidelines were developed for harmonizing measures to be collected across ATN studies.ResultsEight domains were identified for harmonization—Demographics and Socioeconomic Characteristics, Sexual Behavior and Risk, Substance Use and Abuse, HIV-Positive Cascade, HIV-Negative Cascade, Mental Health, Social Support and Isolation, and Pre-exposure Prophylaxis Cascade.ConclusionsThe collection of selected key measures in a uniform manner across studies facilitates the characterization of participant populations, comparisons between studies, and pooled analysis of data from multiple studies.

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Psychiatric Disorders, Antiretroviral Medication Adherence and Viremia in a Cohort of Perinatally HIV-Infected Adolescents and Young Adults

Abstract: Addressing psychiatric disorder and SUD among PHIV+ AYA may improve ART adherence outcomes in this population. Targeted interventions should be developed and tested.

Cited by 41 publications

References 36 publications

Mental Health Diagnoses, Symptoms, and Service Utilization in US Youth with Perinatal HIV Infection or HIV Exposure

Mental Health Diagnoses, Symptoms, and Service Utilization in US Youth with Perinatal HIV Infection or HIV Exposure

Mental health and HIV/AIDS

Adolescent Medicine Trials Network for HIV/AIDS Interventions Data Harmonization: Rationale and Development of Guidelines

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