Adherence to antiretroviral therapy, stigma and behavioral risk factors in HIV-infected adolescents in Asia

ABSTRACT

We studied behavioral risks among HIV-infected and uninfected adolescents using an audio computer-assisted self-interview. A prospective cohort study was initiated between 2013 and 2014 in Malaysia, Thailand, and Vietnam. HIV-infected adolescents were matched to uninfected adolescents (4:1) by sex and age group (12–14 and 15–18 years). We enrolled 250 HIV-infected (48% male; median age 14.5 years; 93% perinatally infected) and 59 uninfected (51% male; median age 14.1 years) adolescents. At enrollment, HIV-infected adolescents were on antiretroviral therapy (ART) for a median (IQR) of 7.5 (4.7–10.2) years, and 14% had HIV-RNA >1000 copies/mL; 19% reported adherence <80%. Eighty-four (34%) HIV-infected and 26 (44%) uninfected adolescents reported having ever smoked cigarettes or drunk alcohol (p = 0.13); 10% of HIV-infected and 17% of uninfected adolescents reported having initiated sexual activity; 6 of the HIV-infected adolescents had HIV-RNA >1000 copies/mL. Risk behaviors were common among adolescents, with few differences between those with and without HIV.

KEYWORDS:

• HIV
• adolescents
• Asia
• adherence
• stigma

Acknowledgements

The authors are grateful to the study participants and all site staff for their commitment to the study. The TREAT Asia Pediatric HIV Observational Database using an Audio Computer-Assisted Self-Interview (TApHOD ACASI) Study Group: W Prasitsuebsai, K Pruksakaew, S Kerr, and S Thammasala, The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand; P Lumbiganon, P Kosalaraksa, and P Tharnprisan, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand; R Hansudewechakul, S Denjanta, A Kongphonoi, and W Srisuk, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand; K Chokephaibulkit, S Sricharoenchai, Y Durier, and S Kanakool, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; KH Truong, QT Du, and HD Tran, TKP Le Children’s Hospital 1, Ho Chi Minh City, Vietnam; LV Nguyen, DTK Khu, GTT Thuy, and LT Nguyen, National Hospital of Pediatrics, Hanoi, Vietnam; KA Razali, TJ Mohamed, and NADR Mohammed, Pediatric Institute, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia; Hospital Raja Perempuan Zainab II, Kelantan, Malaysia; SM Fong, KJ Wong, and F Daut, Hospital Likas, Kota Kinabalu, Malaysia; NK Nik Yusoff, and P Mohamad, AH Sohn, JL Ross, and C Sethaputra, TREAT Asia/ amfAR - The Foundation for AIDS Research, Bangkok, Thailand. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions mentioned above.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Jintanat Ananworanich http://orcid.org/0000-0003-1369-3224

Additional information

Funding

Funding support was provided through a grant to amfAR, The Foundation for AIDS Research, with support from the U.S. National Institutes of Health’s National Institute of Allergy and Infectious Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Cancer Institute, National Institute of Mental Health, and National Institute on Drug Abuse as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907), and additional support from the LIFE+, Austria.