Elaine J Abrams1,2, Claude A Mellins3, Amelia Bucek3, Curtis Dolezal3, Jeannette Raymond3, Andrew Wiznia4, Andrea Jurgrau5, Mahrukh Bamji6, Cheng-Shiun Leu3, Yiu Kee Warren Ng5. 1. ICAP at Columbia University, Mailman School of Public Health, eja1@cumc.columbia.edu. 2. Vagelos College of Physicians and Surgeons, and. 3. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, New York. 4. Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York. 5. New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York; and. 6. Metropolitan Hospital Center, New York, New York.
Abstract
BACKGROUND: Young adults living with perinatally acquired HIV infection (PHIVYAs) are at risk for poor biomedical and behavioral health outcomes. Few studies offer a comprehensive overview of the functioning of this population in young adulthood and the role of HIV. METHODS: Data come from the Child and Adolescent Self-Awareness and Health Study, a longitudinal behavioral health cohort study of PHIVYAs and perinatally HIV-exposed but uninfected young adults (PHEUYAs) who are compared on psychiatric and neurocognitive functioning, sexual and substance use behaviors, health and reproductive outcomes, and young adult milestones. RESULTS: Overall, 27% of participants met criteria for a psychiatric disorder, including mood (11%), anxiety (22%), and substance use (28%), with no HIV status differences. PHIVYAs performed worse on 2 neurocognitive tests. There were no HIV status differences in condomless sex (41%) or pregnancies (41% women; 38% men). Both groups exhibited similar adult milestones: 67% graduated high school or an equivalent, 19% were in college, and 42% were employed. However, 38% were neither in school or working, 12% reported incarceration, and 16% were ever homeless. Among PHIVYAs, 36% were viremic (>200 copies per mL), and 15% were severely immunocompromised (CD4+ cell count <100 cells per mm3). CONCLUSIONS: Many PHIVYAs achieve adult milestones related to school, employment, sexual relationships, and starting families. However, they and PHEUYAs have high rates of psychiatric and substance use disorders and behavioral risks, which can jeopardize long-term health and adult functioning, particularly in the context of HIV. These findings underscore an urgent need to escalate interventions.
BACKGROUND: Young adults living with perinatally acquired HIV infection (PHIVYAs) are at risk for poor biomedical and behavioral health outcomes. Few studies offer a comprehensive overview of the functioning of this population in young adulthood and the role of HIV. METHODS: Data come from the Child and Adolescent Self-Awareness and Health Study, a longitudinal behavioral health cohort study of PHIVYAs and perinatally HIV-exposed but uninfected young adults (PHEUYAs) who are compared on psychiatric and neurocognitive functioning, sexual and substance use behaviors, health and reproductive outcomes, and young adult milestones. RESULTS: Overall, 27% of participants met criteria for a psychiatric disorder, including mood (11%), anxiety (22%), and substance use (28%), with no HIV status differences. PHIVYAs performed worse on 2 neurocognitive tests. There were no HIV status differences in condomless sex (41%) or pregnancies (41% women; 38% men). Both groups exhibited similar adult milestones: 67% graduated high school or an equivalent, 19% were in college, and 42% were employed. However, 38% were neither in school or working, 12% reported incarceration, and 16% were ever homeless. Among PHIVYAs, 36% were viremic (>200 copies per mL), and 15% were severely immunocompromised (CD4+ cell count <100 cells per mm3). CONCLUSIONS: Many PHIVYAs achieve adult milestones related to school, employment, sexual relationships, and starting families. However, they and PHEUYAs have high rates of psychiatric and substance use disorders and behavioral risks, which can jeopardize long-term health and adult functioning, particularly in the context of HIV. These findings underscore an urgent need to escalate interventions.
Authors: Ronald C Kessler; Shelli Avenevoli; E Jane Costello; Katholiki Georgiades; Jennifer Greif Green; Michael J Gruber; Jian-ping He; Doreen Koretz; Katie A McLaughlin; Maria Petukhova; Nancy A Sampson; Alan M Zaslavsky; Kathleen Ries Merikangas Journal: Arch Gen Psychiatry Date: 2011-12-05
Authors: Katherine S Elkington; Zachary Peters; C Jean Choi; Amelia Bucek; Cheng-Shiun Leu; Elaine J Abrams; Claude A Mellins Journal: AIDS Behav Date: 2018-10
Authors: D Shaffer; P Fisher; M K Dulcan; M Davies; J Piacentini; M E Schwab-Stone; B B Lahey; K Bourdon; P S Jensen; H R Bird; G Canino; D A Regier Journal: J Am Acad Child Adolesc Psychiatry Date: 1996-07 Impact factor: 8.829
Authors: Curtis Dolezal; Stephanie L Marhefka; E Karina Santamaria; Cheng-Shiun Leu; Elizabeth Brackis-Cott; Claude Ann Mellins Journal: Arch Sex Behav Date: 2011-05-21
Authors: Shenell D Evans; Claude Ann Mellins; Cheng-Shiun Leu; Patricia Warne; Katherine S Elkington; Curtis Dolezal; E Karina Santamaria; Andrew Wiznia; Mahrukh Bamji; Andrea S Jurgrau-Voulgari; Elaine J Abrams Journal: AIDS Patient Care STDS Date: 2015-01 Impact factor: 5.078
Authors: Philimon Gona; Russell B Van Dyke; Paige L Williams; Wayne M Dankner; Miriam C Chernoff; Sharon A Nachman; George R Seage Journal: JAMA Date: 2006-07-19 Impact factor: 56.272
Authors: Reuben N Robbins; R Zimmerman; R Korich; J Raymond; C Dolezal; C J Choi; C S Leu; N Nguyen; K Malee; A Wiznia; E J Abrams; C A Mellins Journal: AIDS Care Date: 2019-06-07
Authors: Amelia Bucek; Claude Ann Mellins; Cheng-Shiun Leu; Curtis Dolezal; Rehema Korich; Andrew Wiznia; Elaine J Abrams Journal: AIDS Care Date: 2019-09-19
Authors: Stephanie Shiau; Stephen M Arpadi; Megan Burke; Afaaf Liberty; Cara Thurman; Faeezah Patel; Renate Strehlau; Elaine J Abrams; Ashraf Coovadia; Avy Violari; Louise Kuhn Journal: AIDS Care Date: 2019-07-09
Authors: Jane R Millar; Isabella Fatti; Noxolo Mchunu; Nomonde Bengu; Nicholas E Grayson; Emily Adland; David Bonsall; Moherndran Archary; Philippa C Matthews; Thumbi Ndung'u; Philip Goulder Journal: AIDS Date: 2021-08-01 Impact factor: 4.632
Authors: Sharon L Nichols; Sean Brummel; Kathleen M Malee; Claude A Mellins; Anna-Barbara Moscicki; Renee Smith; Anai M Cuadra; Kendall Bryant; Cheryl Anne Boyce; Katherine K Tassiopoulos Journal: AIDS Behav Date: 2021-02-22