Rapid psychosocial function screening test identified treatment failure in HIV+ African youth

Abstract

Psychosocial dysfunction in older children and adolescents is common and may lead to nonadherence to HIV treatments. Poor adherence leads to HIV treatment failure and the development of resistant virus. In resource-limited settings where treatment options are typically limited to only one or two available lines of therapy, identification of individuals at highest risk of failure before failure occurs is of critical importance. Rapid screening tools for psychosocial dysfunction may allow for identification of those children and adolescents who are most likely to benefit from limited psychosocial support services targeted at preventing HIV treatment failure. The Pediatric Symptom Checklist (PSC) is used in high resource settings for rapid identification of at-risk youth. In 692 HIV-infected treated children (ages of 8–< 17 years) in Botswana, having a high score on the PSC was associated with having virologic failure (OR 1.7, 95% CI: 1.1–2.6). The PSC may be a useful screening tool in pediatric HIV.

Keywords:

• HIV
• adolescents
• treatment failure
• psychosocial dysfunction
• Africa

Acknowledgements

The authors would like to thank the clinic staff, patients, and families who helped to make this study possible. This research was supported by a grant for the Penn Center for AIDS Research (CFAR), an NIH-funded program (P30 AI 045008).