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Title: A Longitudinal Study of Behavioral Risk, Adherence, and Virologic Control in Adolescents Living with HIV in Asia
Authors: Jeremy L. Ross
Sirinya Teeraananchai
Pagakrong Lumbiganon
Rawiwan Hansudewechakul
Kulkanya Chokephaibulkit
Truong Huu Khanh
Lam Van Nguyen
Thahira A.Jamal Mohamed
Nik Khairulddin Nik Yusoff
Moy Siew Fong
Wasana Prasitsuebsai
Annette H. Sohn
Stephen J. Kerr
National Hospital of Pediatrics Hanoi
Chulalongkorn University
Faculty of Medicine, Khon Kaen University
Kuala Lumpur Hospital
The HIV Netherlands Australia Thailand Research Collaboration
Faculty of Medicine, Siriraj Hospital, Mahidol University
Hospital Raja Perempuan Zainab II
Children's Hospital 1
Foundation for AIDS Research
Chiangrai Prachanukroh Hospital
Hospital Likas
Keywords: Medicine
Issue Date: 1-Jun-2019
Citation: Journal of Acquired Immune Deficiency Syndromes. Vol.81, No.2 (2019), e28-e38
Abstract: © 2019 Wolters Kluwer Health, Inc. All rights reserved. Background:Adolescents living with HIV (ALHIV) have poorer adherence and clinical outcomes than adults. We conducted a study to assess behavioral risks and antiretroviral therapy outcomes among ALHIV in Asia.Methods:A prospective cohort study among ALHIV and matched HIV-uninfected controls aged 12-18 years was conducted at 9 sites in Malaysia, Thailand, and Vietnam from July 2013 to March 2017. Participants completed an audio computer-assisted self-interview at weeks 0, 48, 96, and 144. Virologic failure (VF) was defined as ≥1 viral load (VL) measurement >1000 copies/mL. Generalized estimating equations were used to identify predictors for VF.Results:Of 250 ALHIV and 59 HIV-uninfected controls, 58% were Thai and 51% females. The median age was 14 years at enrollment; 93% of ALHIV were perinatally infected. At week 144, 66% of ALHIV were orphans vs. 28% of controls (P < 0.01); similar proportions of ALHIV and controls drank alcohol (58% vs. 65%), used inhalants (1% vs. 2%), had been sexually active (31% vs. 21%), and consistently used condoms (42% vs. 44%). Of the 73% of ALHIV with week 144 VL testing, median log VL was 1.60 (interquartile range 1.30-1.70) and 19% had VF. Over 70% of ALHIV had not disclosed their HIV status. Self-reported adherence ≥95% was 60% at week 144. Smoking cigarettes, >1 sexual partner, and living with nonparent relatives, a partner or alone, were associated with VF at any time.Conclusions:The subset of ALHIV with poorer adherence and VF require comprehensive interventions that address sexual risk, substance use, and HIV-status disclosure.
ISSN: 10779450
Appears in Collections:Scopus 2019

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