HIV Care Continuum Outcomes Among Adolescents and Young Adults Living With HIV in Latin America and the Caribbean: Association With Depression and Substance Use - Scorecard - MDSpire

HIV Care Continuum Outcomes Among Adolescents and Young Adults Living With HIV in Latin America and the Caribbean: Association With Depression and Substance Use

  • 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

  • June 17, 2025

  • 0 min

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Clinical Scorecard: Outcomes of HIV Care Continuum in Latin American and Caribbean Adolescents and Young Adults: Links to Depression and Substance Use

At a Glance

CategoryDetail
ConditionHIV in adolescents and young adults with co-occurring depression and substance use
Key MechanismsDepression and substance use negatively impact ART adherence, viral suppression, and retention in care
Target PopulationAdolescents (10–17 years) and young adults (18–24 years) living with HIV in Latin America and the Caribbean
Care SettingHIV care clinics within the Caribbean, Central and South America network for HIV epidemiology (CCASAnet)

Key Highlights

  • 16% prevalence of depression among adolescents and young adults with HIV (AYAWH)
  • High rates of substance use: 58% alcohol, 28% tobacco, 17% cannabis, and 4% cocaine use reported
  • 41% missed one or more ART doses in the past week; 40% had detectable viral loads at survey time

Guideline-Based Recommendations

Diagnosis

  • Screen AYAWH for depression using PHQ-2 followed by PHQ-9 or PHQ-A if positive
  • Assess substance use with standardized tools such as ASSIST-WHO

Management

  • Address depression and substance use as integral components of HIV care to improve ART adherence and viral suppression
  • Provide mental health referrals and interventions for AYAWH diagnosed with depression
  • Implement strategies to support ART adherence, especially in those with perinatally acquired HIV

Monitoring & Follow-up

  • Regularly monitor ART adherence and viral load suppression in AYAWH
  • Track retention in care over time, noting that 73% were retained at one year post-survey

Risks

  • Perinatally acquired HIV is associated with higher odds of unsuppressed viral load
  • Depression and substance use contribute to missed ART doses and virologic failure

Patient & Prescribing Data

Adolescents and young adults with HIV on ART for ≥6 months

Missed ART doses are common and linked to depression and substance use; targeted interventions are needed to improve adherence and viral suppression

Clinical Best Practices

  • Integrate mental health and substance use screening into routine HIV care for adolescents and young adults
  • Use validated screening tools (PHQ-2/PHQ-9/PHQ-A for depression; ASSIST-WHO for substance use)
  • Focus on retention strategies to maintain engagement in care beyond initial treatment
  • Pay special attention to those with perinatally acquired HIV due to higher risk of virologic failure

References

Original Source(s)

HIV Care Continuum Outcomes Among Adolescents and Young Adults Living With HIV in Latin America and the Caribbean: Association With Depression and Substance Use

  • 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

  • June 17, 2025

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