Psychosocial needs of perinatally HIV-infected youths in Thailand: lessons learnt from instructive counseling^†

^†The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.

ABSTRACT

Identifying psychosocial needs of perinatally HIV-infected (pHIV) youth is a key step in ensuring good mental health care. We report psychosocial needs of pHIV youth identified using the “Youth Counseling Needs Survey” (YCS) and during individual counseling (IC) sessions. pHIV youth receiving care at two tertiary-care hospitals in Bangkok or at an orphanage in Lopburi province were invited to participate IC sessions. The youths’ psychosocial needs were assessed using instructive IC sessions in four main areas: general health, reproductive health, mood, and psychosocial concerns. Prior to the IC session youth were asked to complete the YCS in which their concerns in the four areas were investigated. Issues identified from the YCS and the IC sessions were compared. During October 2010–July 2011, 150 (68.2%) of 220 eligible youths participated in the IC sessions and completed the YCS. Median age was 14 (range 11–18) years and 92 (61.3%) were female. Mean duration of the IC sessions was 36.5 minutes. One-hundred and thirty (86.7%) youths reported having at least one psychosocial problem discovered by either the IC session or the YCS. The most common problems identified during the IC session were poor health attitude and self-care (48.0%), lack of life skills (44.0%), lack of communication skills (40.0%), poor antiretroviral (ARV) adherence (38.7%), and low self-value (34.7%). The most common problems identified by the YCS were lack of communication skills (21.3%), poor health attitude and self-care (14.0%), and poor ARV adherence (12.7%). Youth were less likely to report psychosocial problems in the YCS than in the IC session. Common psychosocial needs among HIV-infected youth were issues about life skills, communication skills, knowledge on self-care, ARV adherence, and self-value. YCS can identify pHIV youths’ psychosocial needs but might underestimate issues. Regular IC sessions are useful to detect problems and provide opportunities for counseling.

KEYWORDS:

• HIV-infected youth
• psychosocial needs
• counseling
• behavioral risks
• instructive counseling
• Thailand

Acknowledgements

The authors would like to thank nurses, social workers, care takers, and colleagues from Department of Pediatrics at Siriraj Hospital, The Queen Sirikit National Institute of Child Health, and the orphanage in Lopburi as well as GAP Thailand/Asia Regional office (ARO), TUC, U.S. Centers for Disease Control and Prevention. Thank Dr Michael Martin, a senior technical advisor of the GAP Thailand ARO, for his assistance reviewing and editing the manuscript. Thank Dr Sarika Pattanasin for her assistance in data analysis. Also, a heart-felt thank you to all the youths and their parents or caretakers for their participations.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

^† The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.

Additional information

Funding

The research was supported by the Presidents’ Emergency Plan for AIDS Relief (PEPFAR) through CDC under the terms of [5U19GH000004-04].