Annette H Sohn1, Kulkanya Chokephaibulkit2, Pagakrong Lumbiganon3, Rawiwan Hansudewechakul4, Yasmin Mohamed Gani5, Lam Van Nguyen6, Thahira Jamal Mohamed7, Sirinya Teeraananchai8, Chuenkamol Sethaputra9, Thida Singtoroj9, Jintanat Ananworanich10, Peter Reiss11, Stephen J Kerr12. 1. TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand. Electronic address: annette.sohn@treatasia.org. 2. Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. 3. Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. 4. Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand. 5. Hospital Sungai Buloh/Jalan Hospital, Sungai Buloh, Selangor, Malaysia. 6. National Hospital of Pediatrics, Hanoi, Vietnam. 7. Pediatric Institute, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia. 8. HIV-NAT, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand. 9. TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand. 10. Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland; Department of Global Health, Amsterdam University Medical Centers, University of Amsterdam, and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands. 11. Department of Global Health, Amsterdam University Medical Centers, University of Amsterdam, and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands; HIV Monitoring Foundation, Amsterdam, The Netherlands. 12. HIV-NAT, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand; Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Abstract
PURPOSE: The aim of this article was to study the clinical and social outcomes of health care transition among Asian adolescents and young adults with HIV (AYHIV). METHODS: AYHIV who transferred from a pediatric to an adult clinic within the past year across five sites in Malaysia, Thailand, and Vietnam had clinical and laboratory evaluations and completed questionnaires about their health, socioeconomic factors, and transition experiences. Multiple logistic regression was used to assess associations with HIV viremia. RESULTS: Of 93 AYHIV enrolled between June 2016 and April 2017, 56% were female, 87% acquired HIV through perinatal exposure, median age was 20 years (interquartile range [IQR] 18.5-21). Two-thirds were in a formal education program, 43% were employed, 43% of females and 35% of males were sexually active. Median lifetime antiretroviral therapy duration was 6.2 years (IQR 3.3-10.7); 45% had received second-line therapy. Median CD4 was 601 cells/mm3 (IQR 477-800); 82% had HIV-RNA <40 copies/mL. Being in a relationship, a shorter posttransition duration, self-reported adherence of ≥95%, and higher CD4 were inversely associated with HIV viremia. Half felt very prepared for the transfer to adult care, and 20% frequently and 43% sometimes still met with pediatric providers. Two-thirds reported needing to keep their HIV a secret, and 23%-38% reported never or rarely having someone to discuss problems with. CONCLUSIONS: Asian AYHIV in our cohort were concerned about the negative social impact of having and disclosing HIV, and one-third lacked people they could trust with their personal problems, which could have negative implications for their ability to navigate adult life.
PURPOSE: The aim of this article was to study the clinical and social outcomes of health care transition among Asian adolescents and young adults with HIV (AYHIV). METHODS: AYHIV who transferred from a pediatric to an adult clinic within the past year across five sites in Malaysia, Thailand, and Vietnam had clinical and laboratory evaluations and completed questionnaires about their health, socioeconomic factors, and transition experiences. Multiple logistic regression was used to assess associations with HIV viremia. RESULTS: Of 93 AYHIV enrolled between June 2016 and April 2017, 56% were female, 87% acquired HIV through perinatal exposure, median age was 20 years (interquartile range [IQR] 18.5-21). Two-thirds were in a formal education program, 43% were employed, 43% of females and 35% of males were sexually active. Median lifetime antiretroviral therapy duration was 6.2 years (IQR 3.3-10.7); 45% had received second-line therapy. Median CD4 was 601 cells/mm3 (IQR 477-800); 82% had HIV-RNA <40 copies/mL. Being in a relationship, a shorter posttransition duration, self-reported adherence of ≥95%, and higher CD4 were inversely associated with HIV viremia. Half felt very prepared for the transfer to adult care, and 20% frequently and 43% sometimes still met with pediatric providers. Two-thirds reported needing to keep their HIV a secret, and 23%-38% reported never or rarely having someone to discuss problems with. CONCLUSIONS: Asian AYHIV in our cohort were concerned about the negative social impact of having and disclosing HIV, and one-third lacked people they could trust with their personal problems, which could have negative implications for their ability to navigate adult life.
Authors: Richard C Gershon; Molly V Wagster; Hugh C Hendrie; Nathan A Fox; Karon F Cook; Cindy J Nowinski Journal: Neurology Date: 2013-03-12 Impact factor: 9.910
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