Most adolescents will have commenced ART during earlier childhood and will transition to a fixed-dose combination (FDC) regimen during early adolescence. The FDC regimen chosen will depend upon comorbidities, potential for drug-drug interactions (e.g., with oral contraceptives), prior antiretroviral drug exposure, antiretroviral drug resistance profiles, and any antiretroviral drug intolerances. There is increasing evidence and …
Adolescents face many challenges that can affect their psychosocial wellbeing. These include: the capacity for independence and self-management; an understanding of and ability to cope with potential stigma or discrimination; dealing with family stress, illness or death, orphanhood, and poverty; progress through education with possible cognitive impairment; disclosure to others for emotional and practical support; …
Strategies to develop health independence should be a continual process throughout adolescence. This involves a more sophisticated understanding of HIV infection and the health issues arising from this, including HIV viral loads, CD4+ T counts, ART adherence, implications of antiretroviral drug resistance, and viewing HIV infection as a chronic condition that can be easily controlled …
Transition from paediatric to adult HIV services should be a planned multifaceted process designed to maintain engagement in care, facilitate adolescent health autonomy, maximise adolescent and family satisfaction, and optimise health outcomes. The model of transition will be determined by the availability of services, but should at least involve an integrated process incorporating adolescent and …
Adolescents who acquire HIV infection during adolescence (ie., by horizontal rather than vertical transmission) follow a similar clinical course to that of adults. Antiretroviral therapy should be commenced as soon as practical provided the young person is willing to adhere to therapy.[12],[13] Initial ART regimens are likely to be focused on simplification, given that the …
Adolescents with horizontally-acquired HIV infection Read More »
References Hazra R, Siberry GK, Mofenson LM. Growing up with HIV: children, adolescents, and young adults with perinatally acquired HIV infection. Annu Rev Med, 2010; 61:169-185 Vreeman RC, Scanlon ML, McHenry MS, Nyandiko WM. The physical and psychological effects of HIV infection and its treatment on perinatally HIV-infected children. J Int AIDS Soc, 2015; 18(Suppl …
Toby Syme, Mark Jeanes Victorian HIV Mental Health Service, Infectious Diseases Unit, The Alfred Hospital, Melbourne VIC Last reviewed: October 2019 Introduction People with human immunodeficiency virus (HIV) infection suffer high rates of mental illness. Epidemiological studies indicate that the prevalence of mental illness in this population may be as high as 47.9%. Common diagnoses …
Psychiatric disorders in people with HIV infection Read More »
People with HIV infection suffer high rates of major depression. A meta-analysis found rates of major depression in HIV-positive people to be twice that of matched HIV-negative controls.[15] Rates may increase with HIV disease progression and symptomatic illness.[16] Certain risk factors are associated with an increased risk of depression: a personal or family history of mood disorders, …
Anxiety symptoms are common in people with HIV infection, and are likely to be more prominent at times of significant life stresses and at stages of disease progression.[23] Anxiety disorders, where anxiety is severe and persistent, are also common: surveys have estimated the prevalence of generalised anxiety disorder to be up to 15% of HIV patients …
Manic episodes are more common in people with HIV infection than in the general population.[27] An episode of mania is often associated with poor impulse control, impaired judgment and greater risk-taking behaviours, increasing the chance of contracting or spreading HIV infection. A manic episode may be primary (related to a bipolar disorder) or secondary to a …
Developing a sustainable HIV, Viral Hepatitis and Sexual Health Workforce
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