Abstract
BackgroundSelf-harm in adolescents is of growing concern internationally but limited evidence exists on the prevalence of self-harm in those living with HIV, who may be at higher risk of poor mental health outcomes. Therefore our aim was to determine the prevalence and predictors of self-harm among young people with perinatally-acquired HIV (PHIV) and HIV negative (with sibling or mother living with HIV) young people living in England.Methods303 PHIV and 100 HIV negative young people (aged 12–23 years) participating in the Adolescents and Adults Living with Perinatal HIV cohort study completed an anonymous self-harm questionnaire, as well as a number of standardised mental-health assessments. Logistic regression investigated predictors of self-harm.ResultsThe median age was 16.7 years in both groups, and 40.9% of the PHIV and 31.0% of the HIV negative groups were male. In total 13.9% (56/403) reported having ever self-harmed, with no difference by HIV status (p = 0.089). Multivariable predictors of self-harm were female sex (adjusted odds ratio (AOR) 5.3, (95% confidence interval 1.9, 14.1), p = 0.001), lower self-esteem (AOR 0.9 (0.8, 0.9) per 1 point increase, p < 0.001) and having ever used alcohol (AOR 3.8 (1.8, 7.8), p < 0.001). Self-esteem z-scores for both PHIV and HIV negative participants were 1.9 standard deviations below the mean for population norms.ConclusionsSelf-harm is common among PHIV and HIV negative adolescents in England. Reassuringly however, they do not appear to be at an increased risk compared to the general adolescent population (15–19% lifetime prevalence). The low level of self-esteem (compared to available normative data) in both groups is worrying and warrants further attention.
Highlights
Advancements in the medical care of children with perinatally acquired human immunodeficiency virus (HIV) have substantially improved their prognosis
The objective of this study was to determine the prevalence of self-harm among young people with perinatally-acquired HIV (PHIV) and an appropriate comparison group of HIV negative young people living in England
The Adolescents and Adults Living with Perinatal HIV (AALPHI) cohort study is evaluating the impact of HIV infection and ART exposure on young people with PHIV and HIV negative young people in England
Summary
Advancements in the medical care of children with perinatally acquired human immunodeficiency virus (HIV) have substantially improved their prognosis. Self-harm refers to an intentional act of self-injury or self-poisoning carried out by an individual, irrespective of motivation [3]. It includes behaviours such as cutting, overdose or self-poisoning, self-battering and burning [4]. In large population-based studies, of those adolescents reporting self-harm, cutting was identified as the most prevalent method and repeat episodes of self-harm were common [5,6,7]. Self-harm in adolescents is of growing concern internationally but limited evidence exists on the prevalence of self-harm in those living with HIV, who may be at higher risk of poor mental health outcomes. Our aim was to determine the prevalence and predictors of self-harm among young people with perinatally-acquired HIV (PHIV) and HIV negative (with sibling or mother living with HIV) young people living in England
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