HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York, NY, USA.
AIDS Patient Care STDS. 2011 Jul;25(7):413-22. doi: 10.1089/apc.2011.0025. Epub 2011 May 5.
In a sample of perinatally HIV-infected (PHIV+) and perinatally HIV-exposed, uninfected (PHEU) adolescents, we examined the co-occurrence of behavioral health risks including mental health problems, onset of sexual and drug use behaviors, and (in PHIV+ youth) nonadherence to antiretroviral therapy (ART). Participants, recruited from 2007 to 2010, included 349 youth, ages 10-16 years, enrolled in a cohort study examining the impact of HIV infection and ART. Measures of the above behavioral health risks were administered to participants and primary caregivers. Nearly half the participants met study criteria for at least one behavioral health risk, most frequently, mental health problems (28%), with the onset of sexual activity and substance use each reported by an average of 16%. Among the sexually active, 65% of PHIV+ and 50% of PHEU youth reported unprotected sex. For PHIV +youth, 34% reported recent ART nonadherence, of whom 45% had detectable HIV RNA levels. Between 16% (PHIV+) and 11% (PHEU) of youth reported at least two behavioral health risks. Older age, but not HIV status, was associated with having two or more behavioral health risks versus none. Among PHIV+ youth, living with a birth mother (versus other caregivers) and detectable viral load were associated with co-occurrence of behavioral health risks. In conclusion, this study suggests that for both PHIV+ and PHEU youth, there are multiple behavioral health risks, particularly mental health problems, which should be targeted by service systems that can integrate prevention and treatment efforts.
在一组围产期感染艾滋病毒（PHIV+）和围产期暴露于艾滋病毒但未感染（PHEU）的青少年中，我们研究了行为健康风险的同时发生情况，包括心理健康问题、性行为和药物使用行为的开始，以及（在 PHIV+ 青少年中）抗逆转录病毒治疗（ART）的不依从。参与者是从 2007 年至 2010 年招募的，包括 349 名年龄在 10-16 岁的青少年，他们参加了一项队列研究，研究艾滋病毒感染和 ART 的影响。上述行为健康风险的测量结果由参与者和主要照顾者提供。近一半的参与者符合至少一种行为健康风险的研究标准，最常见的是心理健康问题（28%），性行为和药物使用的开始分别平均由 16%的人报告。在有性行为的青少年中，65%的 PHIV+和 50%的 PHEU 青少年报告有未采取保护措施的性行为。对于 PHIV+青少年，34%的人报告最近有 ART 不依从，其中 45%的人有可检测到的 HIV RNA 水平。16%（PHIV+）和 11%（PHEU）的青少年报告至少有两种行为健康风险。年龄较大，但不是艾滋病毒状况，与存在两种或更多行为健康风险而不是没有风险有关。在 PHIV+青少年中，与其他照顾者相比，与生母一起生活和可检测到的病毒载量与行为健康风险的同时发生有关。总之，这项研究表明，对于 PHIV+和 PHEU 青少年，有多种行为健康风险，特别是心理健康问题，服务系统应该针对这些风险，整合预防和治疗工作。
