Funck-Brentano Isabelle, Assoumou Lambert, Veber Florence, Moshous Despina, Frange Pierre, Blanche Stéphane
AP-HP, Hôpital Necker-Enfants Malades, Unité d'Immunologie-hématologie et rhumatologie pédiatriques, 149 rue de Sèvres, 75743 Paris cedex 15, France.
Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 45 Boulevard de l'Hôpital, 75013 Paris, France; INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 101 rue de Tolbiac, 75013 Paris, France.
Open AIDS J. 2016 Nov 9;10:209-224. doi: 10.2174/1874613601610010209. eCollection 2016.
Resilience of perinatally HIV-infected youth in European countries is poorly studied. Life satisfaction and expectations for adulthood are rarely examined.
This cross-sectional, descriptive study of a French cohort of 54 perinatally HIV-infected adolescents raised in France (age 14-20 years) aimed to (1) evaluate their psychosocial adjustment, (2) identify their expectations for adulthood and (3) delineate risk and protective factors associated with mental health, life satisfaction, and HIV-1 viral load level.
Medical evaluation, psychological semi-structured interview, and self-report questionnaires were used.
All the adolescents had been receiving Highly Active Anti-Retroviral Therapy (HAART) for 9 to 11 years and 2/3 were healthy with controlled viral load (<50 copies/mL). The majority had medium to high levels of life satisfaction. They viewed HIV as having only minor impact on their current daily life and had positive expectations for adulthood. However, 46% exhibited psychiatric symptomatology. Multivariable analysis showed that having a deceased parent and current worries about HIV were substantial risk factors for psychiatric symptoms. Having two living parents and being satisfied with life were protective factors for mental health. Good quality of caregiver-adolescent relationships and high life satisfaction were significant protective factors for controlled viral load.
These data indicate psychosocial resilience among perinatally HIV-1 infected adolescents with 10 years of HAART treatment. These findings demonstrate the influence of life satisfaction, parent's life status and quality of caregiver-adolescent relationships on resilience and health outcomes in these patients. We conclude that healthcare providers should attend to these factors.
欧洲国家围产期感染艾滋病毒青年的心理复原力研究较少。生活满意度和对成年期的期望很少被研究。
这项对在法国长大的54名围产期感染艾滋病毒的青少年（年龄14 - 20岁）的法国队列进行的横断面描述性研究旨在：（1）评估他们的心理社会适应情况；（2）确定他们对成年期的期望；（3）描绘与心理健康、生活满意度和HIV - 1病毒载量水平相关的风险和保护因素。
采用医学评估、心理半结构化访谈和自我报告问卷。
所有青少年均接受高效抗逆转录病毒疗法（HAART）治疗9至11年，三分之二的人健康，病毒载量得到控制（<50拷贝/毫升）。大多数人生活满意度为中高水平。他们认为艾滋病毒对其当前日常生活影响较小，并对成年期抱有积极期望。然而，46%的人表现出精神症状。多变量分析显示，父母一方去世和当前对艾滋病毒的担忧是精神症状的重要风险因素。父母双方健在且对生活满意是心理健康的保护因素。照顾者与青少年关系质量良好和生活满意度高是病毒载量得到控制的重要保护因素。
这些数据表明，接受10年HAART治疗的围产期感染HIV - 1的青少年具有心理社会复原力。这些发现证明了生活满意度、父母生活状况以及照顾者与青少年关系质量对这些患者的复原力和健康结果的影响。我们得出结论，医疗服务提供者应关注这些因素。
