Jeremy L. RossSirinya TeeraananchaiPagakrong LumbiganonRawiwan HansudewechakulKulkanya ChokephaibulkitTruong Huu KhanhLam Van NguyenThahira A.Jamal MohamedNik Khairulddin Nik YusoffMoy Siew FongWasana PrasitsuebsaiAnnette H. SohnStephen J. KerrNational Hospital of Pediatrics HanoiChulalongkorn UniversityFaculty of Medicine, Khon Kaen UniversityKuala Lumpur HospitalThe HIV Netherlands Australia Thailand Research CollaborationFaculty of Medicine, Siriraj Hospital, Mahidol UniversityHospital Raja Perempuan Zainab IIChildren's Hospital 1Foundation for AIDS ResearchChiangrai Prachanukroh HospitalHospital Likas2020-01-272020-01-272019-06-01Journal of Acquired Immune Deficiency Syndromes. Vol.81, No.2 (2019), e28-e3810779450152541352-s2.0-85066163506https://repository.li.mahidol.ac.th/handle/20.500.14594/51633© 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.Mahidol UniversityMedicineArticleSCOPUS10.1097/QAI.0000000000002008