Facing adolescence and adulthood: the importance of mental health care in the global pediatric AIDS epidemic.

With the increasing global accessibility of antiretrovirals, many HIV-positive children now face a future once thought impossible. As these children grow, they face unique psychosocial stressors that differ from any previous chronic or incurable childhood illness. Studies have already described an increased prevalence of mental health disorders among this population. In addition, other studies have illustrated the known future health consequences of adverse childhood experiences, similar but not related to the HIV/AIDS epidemic. This article connects these studies and predicts the grave future health consequences likely to be faced if pediatric mental health care is not addressed. Practical solutions are described that often go hand-in-hand with the current global scale-up of antiretroviral accessibility. These include scaling-up mental health services, educating communities, supporting school-based programs, promoting the role of nongovernmental organizations, and strengthening families and the community to provide a safe and secure home environment for children. HIV-positive children are likely to face future physical and psychological health consequences related to the psychosocial challenges they face as children if mental health care is not made a priority in the current global fight against AIDS.