Beyond Their HIV Status: the Occurrence of Multiple Health Risk Behavior Among Adolescents from a Rural Setting of Sub-Saharan Africa

Derrick Ssewanyana,H Gerry Taylor,Amin S Hassan,Amina Abubakar,Charles R Newton,Gaia Scerif,Alan Stein,Fons Van De Vijver,Anneloes Van Baar

doi:10.1007/s12529-020-09877-6

Abstract

BackgroundHealth risk behaviors during adolescence may cluster into patterns that might be predicted by specific factors, among which HIV may have an important role.MethodIn a cross-sectional study conducted between 2017 and 2018, clustering of HRB and its associated factors was investigated in rural Kenya among 588 adolescents (36% perinatally HIV infected; 28% perinatally HIV exposed but uninfected; and 36% HIV unexposed/uninfected). Latent class analysis of 22 behaviors followed by multinomial logistic regression were conducted. Four risk behavior classes were identified.ResultsNo significant differences were found in behavioral class membership across the three HIV groups (p = 0.366). The risk of membership to the higher risk behavioral classes relative to class 1 (the substance and drug abstinent low risk takers) increased with older adolescent age (p = 0.047), increased among adolescent who experienced mental distress (p < 0.001), and those who felt unsafe in their neighborhood (p < 0.002). Better working memory (p = 0.0037) was found to be protective.ConclusionThe results highlight a need to include screening and interventions for internalizing mental health problems and deficits in executive functioning, as well as steps to involve family members and communities to address psychosocial risk factors in adolescents in Kenya.

Highlights

The emergence of a sub-population of adolescents living with HIV, especially in Sub-Saharan Africa (SSA) [1, 2], has been met with growing research interest on health risk behavior (HRB) of this group [3, 4]
We explored the extent to which perinatal HIV infection influences HRB clustering during adolescence, while controlling for relevant confounding factors tested in a directed acyclic graph (DAG)
All the perinatally HIV-infected adolescents were enrolled on antiretroviral therapy (ART) of whom 17.5% were prescribed protease inhibitor-based regimen

Summary

Introduction

The emergence of a sub-population of adolescents living with HIV, especially in Sub-Saharan Africa (SSA) [1, 2], has been met with growing research interest on health risk behavior (HRB) of this group [3, 4]. Most studies on HRB among adolescents living with HIV in SSA report a high prevalence (20–60%) of risky sexual behavior and sexual victimization as well as substance use behavior, especially among males in late adolescence [3, 4]. These findings make HRB an urgent target for intervention among adolescents living with HIV. Health risk behaviors during adolescence may cluster into patterns that might be predicted by specific factors, among which HIV may have an important role.

Methods

Results

Discussion

Conclusion