HIV-positive Adolescents Research Articles

Enhanced Adherence Counselling, Support Groups and Viral Load Suppression amongst HIV-Positive Adolescents in a Tertiary Health Care Facility in Cameroon

Background: Globally, HIV viral load suppression rate, which is an indirect measure of the efficacy of antiretroviral (ART) medication, is 47% and 52% in Africa. In Cameroon, the viral load (VL) suppression rate is 44.7% and poor adherence is widely documented as being responsible for the large gap in VL Suppression. Enhanced adherence counselling (EAC) sessions, and enrolment and participation in support groups are specific interventions to improve ART adherence and improve viral load suppression. Purpose: This study assesses the uptake and contribution of support groups and EAC sessions in the management of adolescents with unsuppressed VL results at Centre Hospitalier d’Essos, Yaounde. Methods: A retrospective correlational quantitative patient files review was conducted for 138 files of HIV positive adolescents aged between 10 - 19 years with HIV VL above 1000 copies/ml enrolled in care between January 2009 and December 2019. Data from the questionnaire was entered into CSPRO version 7.4. and analyzed by using SPSS version 25.0. Results: A total of 138 participants (75 females and 63 males) with a mean age of 15 ± 3 years were included in our study. Sixty-nine (50%) participants were in World Health Organization (WHO) stage I; 32.6% were in Stage II; 13.0% and 4.3% were in stages III and IV, respectively. Thirty (21.7%) had a history of tuberculosis and 76% of the adolescents were being cared for primarily by their parents. The charts of the adolescents revealed that there was an association between completion of EAC sessions in adolescents with unsuppressed VL and eventual VL suppression (R.R = 2.5; CI 0.848 - 6.162; p = 0.033). However, there was no significant association between support group enrolment and active participation, and eventual VL Suppression. Furthermore, combining EAC and support group interventions was strongly associated with eventual VL Suppression in this group of initially unsuppressed adolescents (R.R = 7.5; C.I 2.544 - 22.360; p < 0.001). Conclusion: Suppression rates were good after completion of EAC sessions and participation in support group enrolment for adolescents with a high VL. As we move towards having 95% of ART-treated adolescents achieve and maintain viral suppression, there is a need to reinforce EAC sessions and support group enrolment in ART clinics targeting this priority group.

Self-esteem and self-efficacy among HIV-positive adolescents: an intervention study

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Nimmy Mathew R, M.Y. M. Self-esteem and self-efficacy among HIV-positive adolescents: an intervention study. HIV & AIDS Review. International Journal of HIV-Related Problems. 2022;21(1):37-42. doi:10.5114/hivar.2022.112718. APA Nimmy Mathew, R., & M.Y., M. (2022). Self-esteem and self-efficacy among HIV-positive adolescents: an intervention study. HIV & AIDS Review. International Journal of HIV-Related Problems, 21(1), 37-42. https://doi.org/10.5114/hivar.2022.112718 Chicago Nimmy Mathew, Rosa, and Manjula M.Y. 2022. "Self-esteem and self-efficacy among HIV-positive adolescents: an intervention study". HIV & AIDS Review. International Journal of HIV-Related Problems 21 (1): 37-42. doi:10.5114/hivar.2022.112718. Harvard Nimmy Mathew, R., and M.Y., M. (2022). Self-esteem and self-efficacy among HIV-positive adolescents: an intervention study. HIV & AIDS Review. International Journal of HIV-Related Problems, 21(1), pp.37-42. https://doi.org/10.5114/hivar.2022.112718 MLA Nimmy Mathew, Rosa et al. "Self-esteem and self-efficacy among HIV-positive adolescents: an intervention study." HIV & AIDS Review. International Journal of HIV-Related Problems, vol. 21, no. 1, 2022, pp. 37-42. doi:10.5114/hivar.2022.112718. Vancouver Nimmy Mathew R, M.Y. M. Self-esteem and self-efficacy among HIV-positive adolescents: an intervention study. HIV & AIDS Review. International Journal of HIV-Related Problems. 2022;21(1):37-42. doi:10.5114/hivar.2022.112718.

Physical development and mental health in South African perinatally HIV-positive adolescents on antiretroviral therapy and their caregivers with and without household food insecurity.

BackgroundPerinatally acquired HIV-infected (PHIV+) adolescents have shown impairments in neurocognitive function and mental health problems compared with their peers. The contribution of food insecurity to such impairments has not been explored.ObjectivesThe aim of this report has been to explore the contribution of food insecurity to neurocognitive impairment and mental health problems in adolescents with perinatally-acquired HIV infection.MethodA total of 248 PHIV+ adolescents and healthy controls aged between 9 and 12 years completed a neuropsychological battery, the Childhood Behaviour Checklist (CBCL) and the Becks Youth Inventory. Head circumference, body mass index (BMI), height for age (HAZ), Tanner pubertal staging, albumin, haemoglobin, CD4 and viral loads were also measured. Participants’ caregivers were interviewed about their mental health and household food security. T-tests were used to assess for differences in food secure and food insecure households.ResultsCaregivers of PHIV+ adolescents reported higher levels of depressive symptoms and household food insecurity. Increased food insecurity was associated with more behavioural problems in adolescents, as well as lower haemoglobin and albumin levels, faster processing speed and increased Tanner staging in boys. Body mass index and HAZ were not affected by food insecurity.ConclusionThese findings suggest that household food insecurity is associated with some altered behavioural, physical and physiological outcomes, which could complicate and compound the existing difficulties in PHIV+ households.

Facilitators and barriers to antiretroviral therapy adherence among HIV-positive adolescents living in Tanzania

BackgroundAdolescents living with HIV face substandard outcomes along the continuum of care, including higher rates of poor adherence and virologic failure. Support groups have been identified as a method to improve adherence, but there is insufficient evidence regarding their effectiveness. This study seeks to examine the protective influences for and barriers to antiretroviral therapy (ART) adherence in HIV-positive adolescents living in Tanzania.MethodsThis is a qualitative study conducted in Tanzania from January to March 2018. The sample of adolescents aged 10-19 (n = 33) was purposefully selected based on age, gender, and support group attendance to capture a broad range of experiences. Participants completed an in-depth interview, covering topics such as retention in HIV services, support group experiences, and joys and challenges of adolescent life. Interviews were coded and themes related to ART adherence were identified and summarized.ResultsSupport groups helped promote adherence by improving adolescents’ knowledge and confidence. Participants associated joining support groups with an improvement in health. Almost every participant described the significant positive influence a treatment supporter had on adherence. Adolescents’ daily schedules and emotional state served as a barrier to adherence. Furthermore, adherence was negatively impacted by participants’ fear of accidental disclosure.ConclusionLogistical and psychosocial factors can hinder adherence. Interventions that provide both education and psychosocial support, such as peer support groups, have the potential to improve health outcomes for this population, but may not address more persistent barriers to adherence rooted in lack of treatment support from family members or friends who have not been disclosed to, or lack of transportation funds/food security.

Measuring adherence to ARVs among HIV-positive adolescents in Cameroon: a comparative assessment of self-report and medication possession ratio methods.

Introductionadherence to ARV medications has been shown to improve treatment outcomes in HIV positive patients. Given that ARV treatment is lifelong, adherence has become a critical issue as it may reduce over time. Measuring adherence is therefore imperative in programming. There are different methods of measuring adherence each with its advantages and disadvantages, depending on the context and the time. This study therefore compares two widely used adherence measurement scales in Cameroon, namely, the self-report and the medication possession ration (MPR) methods.Methodsthe study was done in some selected health facilities of the North West and South West regions of Cameroon among adolescents on ARV. The study was designed as an analytical cross-sectional study with a record review component and systematic random sampling was used to select the participants. Adherence was measured through self-report and the medication possession ratio. Adolescents with adherence levels of at least 95% were considered adherent. Viral load suppression was considered as having the most recent viral load suppression results of less than 1000 copies per ml. The kappa statistics of inter-rate agreement was used to ascertain the difference between adherence as measured by self-report and MPR. The difference in adherence between the two scales was also compared using Fischer´s exact test and p-values were reported.Resultsthe study shows that adherence level using the self-report technique is 82.9% while that of MPR was 73.4%. When compared using the using Kappa statistics, there was substantial agreement between the two scales of 66% (p=0.54). The results of both self-report adherence and MPR were also compared with viral load suppression and the difference between viral load suppression and MPR was significant (p<0.01). The difference in adherence between viral load suppression and the self-report measure also showed to be significant (p<0.01).Conclusionadherence from the self-report measure was higher than from MPR, but there was substantial agreement between the scales. Although there is no gold standard for adherence measurement, self-report or medication possession ratio could be used and complemented with laboratory markers like viral load counts.

Cancer in HIV-positive and HIV-negative adolescents and young adults in South Africa: a cross-sectional study

ObjectiveTo determine the spectrum of cancers in adolescents and young adults (AYAs) living with and without HIV in South Africa.DesignCross-sectional study with cancer records provided by the National Cancer Registry...

Transitioning Adolescents with Perinatally Acquired HIV from Paediatric to Adult Centered Care: Caregivers’ Perspective

Aim: To investigate caregivers’ attitude towards transitioning HIV-positive adolescents from paediatric to adult centered care as well as understanding their perspective of transition inhibitors and facilitators.&#x0D; Study Design: We used a descriptive qualitative design and purposively selected principal caregivers of adolescents aged 15 to 19 years with perinatally acquired HIV who had been attending the paediatric infectious diseases clinic for at least 12 months before the study.&#x0D; Place and Duration of Study: Rivers State University Teaching Hospital, Port Harcourt, Nigeria. The study was conducted from August 2020 to November 2020.&#x0D; Methodology: We included principal caregivers whose wards were not cognitively impaired, whose HIV serostatus had been disclosed to them and who had been attending the Rivers State University Teaching Hospital paediatric infectious diseases clinic for at least 12 months before the onset of the study. Fifteen In-depth interviews were conducted and data was analyzed using the thematic analysis method with Atlas ti data qualitative software version 7.5.21. The sample size was determined when data saturation was reached.&#x0D; Results: Most principal caregivers did not understand their role and were not involved in preparing their wards for the transition to adult care. Perceived inhibitors to transition were anxiety on severing the long-term relationship with the paediatric health care team and concern that adult physicians may not be as caring as those in the paediatric clinic. Seropositive caregivers suggested that taking their wards along with them to their appointment at the adult clinic would facilitate transition. &#x0D; Conclusion: Principal caregivers were unaware of their roles in the transition process, healthcare providers should actively involve and educate them to ensure a smooth transitioning to the adult centered care.

Assessment of Adherence to Antiretroviral Therapy, Associated Factors, and Relationship to CD4 Cell Count Recovery among HIV-Positive Adolescents

Background: Adherence to antiretroviral therapy (ART) in HIV-positive adolescents (HPAs) is an enormous challenge in pediatric HIV management. Suboptimal adherence (OA) encourages treatment failure and HIV transmission. Several factors are inimical to OA, among HPA. Objective: The factors which influence adherence to ART in HPA accessing care in Nnewi, Nigeria, were determined. Subjects and Methods: One hundred and fifty HPAs, aged 10–19 years, who had been on ART for at least 6 months were recruited; 75 each for groups 10–14 and 15–19 years. Sociodemographic data were collected using interviewer-administered questionnaires. Relevant clinical data were retrieved from medical records, and current CD4 cell counts assayed. Results: There were 77 males and 73 females. OA to ART was defined as intake of ≥95% of antiretrovirals over a given period. Using pill count (PC), 74.7% (112/150) had OA. Using the preceding 28-day self-report (P28DSR), 84.0% (126/150) had OA, while for the preceding seven-day self-report (P7DSR), it was 89.3% (134/150). Factors significantly associated with sub-OA were tertiary education, missed clinic visits, travel time to facility ≤1 h, persistent feeling of sadness, and fear of death. Subjects with OA had a significantly higher rate of CD4 cell count recovery compared to those having sub-OA. Conclusion: Sub-OA is common in HPA and can be assessed with a combination of PC and preceding P28DSR, in resource-poor settings. As OA is crucial to CD4 cell count recovery, the latter can be useful in monitoring adherence in HPA.

The role of self-efficacy in HIV treatment adherence and its interaction with psychosocial factors among HIV positive adolescents in transition to adult care in Kenya

ABSTRACT Adolescents and young adults (15–24 yrs.) have poorer HIV clinical outcomes than adults. Despite this, there is minimal data on individual-level factors such as self-efficacy towards antiretroviral adherence among perinatally infected adolescents living with HIV in sub-Saharan Africa. Our study examined the interaction between antiretroviral treatment adherence self-efficacy and other psychosocial factors among adolescents receiving care in Nairobi, Kenya. We enrolled perinatally infected Adolescent Living with HIV (ALWHIV) 16–19 yrs. who were accessing care routinely at the HIV clinic. We measured self-reported ART adherence (7-day recall) and defined optimal adherence as >95%, and conducted a regression analysis to identify independently associated factors. Mediation analysis explored interactions between the psychosocial variables. We enrolled 82 ALWHIV median age 17 (IQR 16,18) who had been on ART for a median age of 11 yrs. (IQR 7,13). Sixty-four per cent (52) of the ALWHIV reported optimal adherence of >95%, and 15% reported missing doses for three or more months. After controlling for the other covariates, self-esteem, high viral load and an adherence level > 95% were significantly associated with adherence self-efficacy. Self-esteem was significantly associated with adherence self-efficacy and social support (p < 0.001 and p = 0.001), respectively. The paramed test indicated that the association between self-efficacy and adherence was mediated by self-esteem with a total effect of OR 6.93 (bootstrap 95% CI 1.99–24.14). Adherence self-efficacy was also mediated by self-esteem in developing adherence behavior. Interventions focused on increasing adherence among ALWHIV should include self-esteem building components.Key words : Adolescents, Adherence self -efficacy, Transition , perinatal,

A Psychoanalysis for the Black Vertically Infected HIV-Positive Adolescent

While working in the public hospital context in Johannesburg, we were confronted with the challenge of thinking about why vertically infected HIV-positive adolescents were consistently defaulting o...

Experiences of intimate relationships, stigma, social support and treatment adherence among HIV-positive adolescents in Chiredzi district, Zimbabwe

This study explored experiences of intimate relationships, stigma, social support and treatment adherence among HIV-positive adolescents in Chiredzi district, Zimbabwe. The study adopted an interpretive qualitative methodology to explore the intricacies of living with HIV as an adolescent. Thirty (N = 30) adolescents aged between 13 and 19 years participated in this study. They were recruited while attending social support or during their routine visits to collect antiretrovirals. In-depth interviews were conducted to generate data. Adolescents were asked about their romantic lives and the difficulties they faced while living with HIV. Findings revealed that adolescents living with HIV (ALHIV) are confronted with stigma and discrimination. They also grapple with emotional issues such as dealing with disclosure. However, social support minimises the risk of harbouring suicidal thoughts. To the various challenges ALHIV face, most of them (particularly males) adopt several coping mechanisms. These include (but are not limited to) non-disclosure of their seropositive status to sexual partners, thereby risking reinfection and exposing their partners to HIV. Non-disclosure of seropositive status contributed to either poor antiretroviral therapy (ART) adherence or defaulting on HIV medication. A life-cycle approach to HIV prevention and management is crucial to mitigating the challenges faced by ALHIV because risks of HIV infection, challenges of access to HIV services and solutions to these challenges change at different stages of someone’s life. This scenario justifies the necessity of a holistic bio-psychosocial approach to managing HIV among adolescents, not only limited to the client, but also involving appropriate education programmes for the broader community.

Short report: knowledge and perceptions of health workers that strengthen adherence for paediatric and adolescent clients on the intensive adherence counselling program in Kampala, Uganda. A qualitative study

Background: Health care workers (HWs) support HIV positive children and adolescents with detectable HIV viral loads on the intensive adherence counselling (IAC) program to achieve viral suppression through individual adherence counselling. Low re-suppression rates of 23% showed low program effectiveness in fifteen public health facilities.&#x0D; Objectives: We set out to determine the knowledge and perceptions of HWs that support this program to improve its effectiveness.&#x0D; Methods: We conducted a qualitative study where five HWs that oversee clinical care for children on ART were interviewed about the program. Data on their knowledge of the program, and perceptions on why it was not effective was collected. Thematic analysis using the inductive approach was used. Transcripts were read, coded and emergent themes determined.&#x0D; Results: Five HWs participated and all were knowledgeable about the program. Two themes emerged as barriers to IAC program effectiveness, patient factors and health system factors. Patient factors were failure to attend appointments, failure to change adherence practices, and lack of consent. Health system factors were work overload, delay in getting results and drug stock outs.&#x0D; Conclusion: HWs are knowledgeable about the IAC program and client specific barriers should be addressed to improve viral suppression for children.&#x0D; Keywords: Intensive adherence counselling; health care worker barriers.

Short report: knowledge and perceptions of health workers that strengthen adherence for paediatric and adolescent clients on the intensive adherence counselling program in Kampala, Uganda: a qualitative study.

Health care workers (HWs) support HIV positive children and adolescents with detectable HIV viral loads on the intensive adherence counselling (IAC) program to achieve viral suppression through individual adherence counselling. Low re-suppression rates of 23% showed low program effectiveness in fifteen public health facilities. We set out to determine the knowledge and perceptions of HWs that support this program to improve its effectiveness. We conducted a qualitative study where five HWs that oversee clinical care for children on ART were interviewed about the program. Data on their knowledge of the program, and perceptions on why it was not effective was collected. Thematic analysis using the inductive approach was used. Transcripts were read, coded and emergent themes determined. Five HWs participated and all were knowledgeable about the program. Two themes emerged as barriers to IAC program effectiveness, patient factors and health system factors. Patient factors were failure to attend appointments, failure to change adherence practices, and lack of consent. Health system factors were work overload, delay in getting results and drug stock outs. HWs are knowledgeable about the IAC program and client specific barriers should be addressed to improve viral suppression for children.

The 5-HTTLPR-rs25531 S-A-S-A Haplotype and Chronic Stress Moderate the Association Between Acute Stress and Internalizing Mental Disorders Among HIV+ Children and Adolescents in Uganda.

Background: Internalizing mental disorders (IMDs) among HIV-positive (HIV+) children and adolescents are associated with poor disease outcomes, such as faster HIV disease progression. Although it has been suggested that the development of IMDs is moderated by interaction of stressful life events and vulnerability factors, the underlying etiology is largely unknown. Serotonin transporter gene [solute carrier family 6 member A4 (SLC6A4)] and human tryptophan hydroxylase 2 gene (TPH2) polymorphisms have been implicated in the development of IMDs. This study investigated the association between acute stress and IMDs, and moderation by chronic stress and genetic variants in SLC6A4 and TPH2.Hypothesis: Acute stress acts through genetic and environmental vulnerability factors to increase the risk of developing IMDs.Methods: Polymorphisms in SLC6A4 (5-HTTLPR, rs25531, 5-HTTLPR-rs25531, and STin2 VNTR) and TPH2 (rs1843809, rs1386494, rs4570625, and rs34517220) were genotyped in 368 HIV+ children and adolescents (aged 5–17 years) with any internalizing mental disorder (depression, anxiety disorders, or posttraumatic stress disorder), and 368 age- and sex-matched controls, who were also HIV+. Chronic and acute stress categories were derived by hierarchical cluster analysis. Logistic regression analysis was used to assess the independent moderating effect of chronic stress and each selected polymorphism on the association between acute stress and IMDs.Results: We observed a statistically significant association between severe acute stress and IMDs (p = 0.001). Children and adolescents who experienced severe acute stress were twice as likely to develop IMDs, compared to children and adolescents who experienced mild acute stress (p = 0.001). Chronic stress interacted with severe acute stress to increase the risk of IMDs (p = 0.033). Acute stress was found to interact with 5-HTTLPR-rs25531 S-A-S-A haplotype to increase the risk for IMDs among Ugandan HIV+ children and adolescents (p = 0.049). We found no evidence for a combined interaction of acute stress, chronic stress, and 5-HTTLPR-rs25531 on IMDs.Conclusion: The odds of having an internalizing mental disorder (IMD) were higher among HIV+ children and adolescents who experienced severe acute stress compared to HIV+ children and adolescents who experienced mild acute stress. Chronic stress and 5-HTTLPR-rs25531 independently moderated the association between acute stress and IMDs.

Correlation between Stigma and Adherence to ART among HIV-Positive Adolescents: A Cross-Sectional Study

Despite the prominence of youth on the global agenda, young people are often left behind in national HIV responses. UNAIDS estimates indicate that AIDS-related deaths among young people are increasing. One of the reasons for this is poor prioritization of adolescents in national plans for scale-up of HIV testing, treatment and counseling services. The objectives of the current study was to: (1) To understand the social issues such as stigma and disclosure faced by them (2) To document the adherence to ART among them and study the effect of stigma on it. The cross-sectional study was conducted at HIV clinic, at ART Centre, Surat (Tertiary Care Level Institute) among adolescents between age-group 13-19 years during December-2015 to February-2016. By purposive sampling following desk review of Hospital data, 105 participants were enrolled. Frequency distribution, Factor analysis and Correlation were utilized for analysis. Around 80% feared that they will lose their friends if they came to know about their serostatus. Factor analysis yielded 2 factors- Blaming and Distancing. These two factor scores were found significantly correlated to adherence to ART. Only 7% chose to share about the status with friends outside the family. The study findings suggest that there is a need for prioritizing adolescent health among seropositives as their difficulties are different than children and adults in handling social issues like stigma due to their age and peer pressure. The lack of knowledge and fear of stigma among them if not addressed may lead to poor adherence to treatment and therefore, clinical complications.

Health and social outcomes of HIV-vulnerable and HIV-positive pregnant and post-partum adolescents and infants enrolled in a home visiting team programme in Kenya.

ObjectivesHIV‐positive and HIV‐vulnerable pregnant adolescent girls and adolescent mothers face significant barriers and vulnerabilities. Infants born to adolescent mothers are also more likely to die and be exposed to life‐threatening conditions. This paper presents findings from an evaluation of a programme that used a home visitation model and offered a case‐management, team‐focused approach to increase family and community supportiveness to enhance health and social service uptake among pregnant adolescent girls and adolescent mothers in Kenya.MethodsThe study used a quasi‐experimental design with before and after comparisons among a non‐randomised population to examine the effectiveness of bi‐monthly household visits to 384 enrolled pregnant adolescent girls, adolescent mothers (ages 10–19) and their infants (0–24 months) between March 2018 and February 2019 in three counties in Kenya.ResultsDuring the programme, household support increased from 57% to 85%, while 100% of eligible participants were on ART and virally suppressed (total of 20 adolescents). Nearly all pregnant adolescent girls (94%) delivered under skilled care vs. 78% of those who were post‐partum at the time of enrolment (P < 0.001); 100% of infants (total of 17 infants) had an up‐to‐date PCR test with no seroconversions. Uptake of modern family planning increased from 39% at baseline to 64% at end line (P < 0.001). The referral rate declined from 84% to 78% from baseline to end line with low uptake of referrals for mental health services (17.3%).ConclusionsA team‐focused approach of home visits to HIV‐vulnerable and HIV‐positive pregnant and post‐partum adolescent girls and their infants combined with efforts to reduce stigma and increase supportiveness of households and the community can help address critical socio‐cultural and behavioural barriers to accessing and using health and social services.

\u201cWhen you have a high life, and you like sex, you will be afraid\u201d: a qualitative evaluation of adolescents\u2019 decision to test for HIV in Zambia and Kenya using the health belief model

BackgroundHIV testing among adolescents is significantly lower than among adults and many adolescents living with HIV do not know their status. Adolescent perceptions of HIV testing are poorly understood and may negatively affect testing uptake. Using a qualitative design, this study sought to explore perceptions about HIV testing and treatment among adolescents living with HIV and adolescents of unknown HIV status in Lusaka, Zambia and Kenya.MethodsStudy participants were adolescents aged 15–19 years old. The adolescents living with HIV were recruited from HIV support groups at health facilities. Adolescents of unknown HIV status were recruited from existing adolescent groups within the community. In both Zambia and Kenya, four focus group discussions (FGDs) were conducted with adolescents living with HIV and four FGDs were conducted with adolescents whose HIV status was unknown, for a total of 16 FDGs. FGDs consisted of 6–12 participants, a moderator, and a note-taker. FGDs were audio-recorded, transcribed, and translated into transcripts. Transcripts were coded in the qualitative analysis software program MAXQDA v. 12. Data reduction and summary tables were generated to help identify themes across the two study population groups. Data were interpreted within the health belief model.ResultsAdolescents discussed the challenges of facing a positive HIV test result, including fear of a positive result and need to change their lifestyle, fear of social isolation, and perception of the lost opportunity to achieve future dreams. Most adolescents of unknown status were not as aware of the benefits of learning their HIV status, nor were they aware of the ability to live a long and healthy life on ART. HIV-positive adolescents reported that the messages targeted towards adolescents focus on the need to remain HIV-negative, as opposed to the benefits of knowing one’s status. Adolescents described age and requirements for parental permission as a significant limitation in their ability to access HIV testing.ConclusionsAdolescents require more information about the benefits of testing early and the ability to live a long and healthy life on ART. Educating adolescents that HIV testing is a normative behavior among their peers could strengthen HIV testing among adolescents.

Nutritional Status and Its Associated Factors Among HIV Positive Adolescents on Atazanavir-Based Regimen Attending an Urban Clinic in Uganda

Nutritional Status and Its Associated Factors Among HIV Positive Adolescents on Atazanavir-Based Regimen Attending an Urban Clinic in Uganda

Depression, Anxiety and Well-Being Among HIV-Positive Adolescents in Lagos, Nigeria

Depression, Anxiety and Well-Being Among HIV-Positive Adolescents in Lagos, Nigeria

1537. Incidence, Reinfection, and Discrepancy Between Site Positivity and Reported Sexual Practice of Sexually Transmitted Infections in HIV-Positive Adolescents and Young Adults in Atlanta, GA

BackgroundHIV-positive adolescents and young adults (AYAs) are disproportionately affected by sexually transmitted infections (STIs). Despite national recommendations, STI screening remains low. Incomplete screening in addition to inconsistent reported sexual practices may lead to missed infections. This study aimed to determine the incidence and reinfection rates of co-STIs in HIV-positive AYAs and the discrepancy between site positivity and self-reported sexual history in this group.MethodsRetrospective chart review was conducted for all patients aged 13-24 at Grady Ponce and Family Youth Clinic in Atlanta, GA from 2009-2018. Data were collected on demographics and STI events. STIs included gonorrhea (GC), chlamydia (CT), human papillomavirus (HPV), syphilis, trichomonas, herpes simplex virus (HSV), lymphogranuloma venereum (LGV), hepatitis C (HCV), bacterial vaginosis (BV), and chancroid. First STI incidence and incidence of reinfections were calculated by dividing new cases over corresponding person follow-up time.Results621 sexually active HIV-positive AYAs were included. The mean age at first observation was 18.7 (±3.29) years. 72.1% of patients were male, 92.3% were Black, and 79.7% were horizontally infected. 83.7% of patients had at least one STI during the study period. The overall first STI incidence rate was 35.8 per 100 person-years with HPV, GC, CT, and syphilis as the most common STIs reported (Table 1). The overall recurrent incidence rate was 72.1 per 100 person-years with GC, CT, and syphilis as the most common recurrent infections (Table 1). Of all GC and CT infections, the majority were rectal (48.7% and 49.9%, respectively) (Table 2). Only 65.8% of patients with rectal GC and 68.5% with rectal CT infections reported recent receptive anal sex (Table 3).Table 1: First and recurrent incidence rates of any STI and individual STIs per 100 person-years Table 2: STIs by site, all infections Table 3: Reported exposure history vs. STI site positivity ConclusionOur study demonstrates disproportionately high incidence and reinfection rates of co-STIs in HIV-positive AYAs. Furthermore, many patients did not report exposure at their site of infection. If screening is done based off reported exposure history alone, many infections may be missed. Our data support the urgent need for increased STI screening in this population, including routine extragenital testing for GC and CT even without reported exposure at these sites.Disclosures All Authors: No reported disclosures