HIV Care Continuum Outcomes Among Adolescents and Young Adults Living With HIV in Latin America and the Caribbean: Association With Depression and Substance Use - Report - MDSpire
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HIV Care Continuum Outcomes Among Adolescents and Young Adults Living With HIV in Latin America and the Caribbean: Association With Depression and Substance Use
Outcomes of HIV Care in Latin American and Caribbean Adolescents and Young Adults
Overview
This study evaluated depression, substance use, ART adherence, viral suppression, and retention in care among 625 adolescents and young adults with HIV (AYAWH) in Latin America and the Caribbean. Depression was present in 16% of participants, substance use was common, and 40% had detectable viral loads. Perinatally acquired HIV was associated with higher odds of unsuppressed viral load.
Background
Adolescents and young adults with HIV face unique challenges including increased risk of virologic failure, loss to follow-up, and mortality. Mental health disorders such as depression and substance use are prevalent in this population and negatively impact treatment adherence and outcomes. Data from Latin America and the Caribbean on these associations are limited. Understanding these factors is critical to improving HIV care continuum outcomes in this vulnerable group.
Data Highlights
Measure
Prevalence/Value
Depression prevalence
16%
Alcohol use
58%
Tobacco use
28%
Cannabis use
17%
Cocaine use
4%
Missed ≥1 ART dose in past week
41%
Detectable viral load at survey
40%
Retention in care at 1 year
73%
Key Findings
Depression was identified in 16% of AYAWH, with males and younger adolescents less likely to be depressed.
Substance use was common: 58% reported alcohol use, 28% tobacco, 17% cannabis, and 4% cocaine.
41% of participants missed one or more ART doses in the week prior to survey completion.
40% had detectable viral loads, with perinatally infected youth having 2.4 times higher odds of unsuppressed viral load.
Retention in care at one year post-survey was 73%, with no significant association to depression or substance use.
Clinical Implications
Screening for depression and substance use should be integrated into routine HIV care for adolescents and young adults to identify those at risk for poor ART adherence and virologic failure. Special attention is warranted for youth with perinatally acquired HIV due to their higher risk of unsuppressed viral load. Interventions targeting mental health and substance use may improve HIV outcomes in this population.
Conclusion
Depression and substance use are prevalent among AYAWH in Latin America and the Caribbean and are associated with suboptimal ART adherence and viral suppression. Addressing these comorbidities is essential to improving HIV care continuum outcomes in this vulnerable group.
References
Joint United Nations Programme on HIV/AIDS 2023 -- Global HIV Statistics
CCASAnet Study Group -- Outcomes of HIV Care Continuum in Latin American and Caribbean Adolescents and Young Adults
by Daisy Maria Machado, Stephany N Duda, Regina Célia de Menezes Succi, Ahra Kim, Paridhi Ranadive, Vanessa Rouzier, Brenda Crabtree-Ramírez, Marco T Luque, Fernando Mejia, Fernanda Rodríguez, Jorge Pinto, Sandra Wagner Cardoso, Fernanda Maruri, Bryan E Shepherd, Catherine C McGowan, Anna K Person
Investigative report cites internal communications, VAERS data, and CDC case reviews describing myocarditis and pericarditis reports in adolescents and young adults after mRNA COVID-19 vaccination.
