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. 2023 Mar;72(3):471-479.
doi: 10.1016/j.jadohealth.2022.10.021. Epub 2022 Dec 17.

Long-Term Post-Transition Outcomes of Adolescents and Young Adults Living With Perinatally and Non-perinatally Acquired HIV in Southeast Asia

Annette H Sohn  1 , Thida Singtoroj  2 , Kulkanya Chokephaibulkit  3 , Pagakrong Lumbiganon  4 , Rawiwan Hansudewechakul  5 , Yasmin Mohamed Gani  6 , Lam Van Nguyen  7 , Montida Auayporn  8 , Stephen Kerr  9
Affiliations

Long-Term Post-Transition Outcomes of Adolescents and Young Adults Living With Perinatally and Non-perinatally Acquired HIV in Southeast Asia

Annette H Sohn et al. J Adolesc Health. 2023 Mar.

Abstract

Purpose: We assessed factors associated with clinical, social, and behavioral outcomes of adolescents and young adults with HIV (AYHIV) in Southeast Asia after transition from pediatric to adult HIV care.

Methods: AYHIV in Malaysia, Thailand, and Vietnam were prospectively followed through annual clinical assessments and laboratory testing. Data were described descriptively and a generalized estimating equation was used to calculate independent predictors for HIV viremia (>40 copies/mL).

Results: A total of 93 AYHIV were followed until February 2019: 60% female, 94% acquired HIV perinatally, 81% Thai, median age 20 (interquartile range, 18-21) years. The median follow-up time was 94 (91-100) weeks; 88% completed the study. At week 96, median CD4 was 557 cells/mm3 (interquartile range, 337-786), 77% had suppressed HIV viral load, 39% reported recent alcohol use, 49% had been sexually active, 53% of females and 36% of males intended to have children, and 23% screened positive for moderate depression (Patient Health Questionnaire-9 score ≥9) or reported suicidal ideation. HIV viremia was associated with <90% adherence to HIV treatment (adjusted incidence rate ratio [aIRR] 2.2 [1.28-3.78]), CD4 count ≤500 cells/mm3 (aIRR 4.75 [2.11-10.69]), and being on a nonnucleoside reverse transcriptase inhibitor regimen (vs. protease inhibitor aIRR 2.71 [1.13-6.49]). Having a trusted person to talk with about their feelings was protective (vs. never; usually or always, aIRR 0.41 [0.18-0.92]).

Discussion: After transition to adult HIV care, there were indications of social isolation and mental health problems that could prevent these AYHIV from maintaining control over their HIV infection and hinder progress toward social independence.

Keywords: Adolescent; HIV; Perinatal; Southeast Asia; Transition; Youth.

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Conflict of interest statement

Conflicts of interest: AHS has received grant support to her institution from and has been a voluntary advisory committee member for ViiV Healthcare. The rest of the authors declare that they have no conflicts of interest.

Figures

Figure 1.
Figure 1.
Social impact questionnaire responses.
Figure 2.
Figure 2.
Social relationship questionnaire responses.
Figure 3.
Figure 3.
Problem-solving questionnaire responses.
See this image and copyright information in PMC

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