Pathways between adverse childhood experiences and viral suppression among male HIV-infected adolescents in South Africa.

Publisher: Informa Healthcare Country of Publication: England NLM ID: 8915313 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1360-0451 (Electronic) Linking ISSN: 09540121 NLM ISO Abbreviation: AIDS Care Subsets: MEDLINE

Publication: London : Informa Healthcare
Original Publication: Abingdon, Oxfordshire, U.K. : Carfax Pub. Co., c1989-

HIV Infections*/drug therapy ; HIV Infections*/epidemiology ; Adverse Childhood Experiences*/ethnology; Humans ; Male ; Adolescent ; South Africa/epidemiology ; Treatment Outcome ; HIV/drug effects ; Anti-HIV Agents/therapeutic use ; Surveys and Questionnaires ; Medication Adherence

Fewer adolescents achieve viral suppression compared to adults. One impediment may be a history of adverse childhood experiences (ACEs). To better develop targets and timeframes for intervention, this study created more robust estimates of the impact of cumulative adversity on viral suppression, tested whether the association is sensitive to the timing of adversity, and simultaneously tested several potential mechanisms. We focus on males, who have lower viral suppression than females and who may contribute to disproportionate incidence among young women. We recruited 251 male perinatally HIV-infected adolescents aged 15-19 from HIV clinics in Soweto, South Africa. Adversity was captured using the Adverse Childhood Experience - International Questionnaire (ACE-IQ). Viral load was measured using blood samples; viral suppression was defined as <20 copies/mL. Indicators of medication adherence, depression, post-traumatic stress disorder (, and substance misuse were captured. A series of pathway analysis were performed. Our sample experienced a median of 7 lifetime and 4 past-year adversities. Less than half (44%) exhibited viral suppression. Adversity demonstrated a significant association with suppression; depression mediated the association. Primary prevention of adversity among children living with HIV is paramount, as is addressing the subsequent mental and behavioral health challenges that impede viral suppression among adolescents.

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R01 MH119878 United States MH NIMH NIH HHS; UM1 AI069453 United States AI NIAID NIH HHS

Keywords: HIV; adolescence; adverse childhood experiences; viral suppression

0 (Anti-HIV Agents)

Date Created: 20240331 Date Completed: 20250313 Latest Revision: 20250313

20250314

PMC11283965

10.1080/09540121.2024.2332451

38555604