‘I don’t even know how to start that kind of conversation’: HIV communication between mothers and adolescents with perinatally acquired HIV

Young people with perinatally acquired HIV are now surviving into late adolescence and adulthood. We explored HIV communication within mother/adolescent dyads following naming of the adolescents’ HIV. Five adolescents with perinatally acquired HIV (14–16 years) and their biological mothers were interviewed separately. HIV communication between mothers and children was rare. Discussion most commonly related to biomedical aspects of HIV. Onward HIV disclosure was discouraged by mothers, which often contrasted with adolescents’ beliefs. Discussing emotional and sexual aspects of HIV was mutually avoided. Culturally sensitive support and guidance should be offered to families about discussing HIV, considering potentially differing perspectives.

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‘We’re touching the topic, but we’re not opening the book:’ A grounded theory study of sibling relationships in young people with perinatally acquired HIV

Journal of Health Psychology ◽

10.1177/1359105320962271 ◽

2020 ◽

pp. 135910532096227

Author(s):

Hannah Deakin ◽

Graham Frize ◽

Caroline Foster ◽

Michael Evangeli

Keyword(s):

Young Adults ◽

Grounded Theory ◽

Young People ◽

Sibling Relationships ◽

Structured Interview ◽

Sibling Relationship ◽

Hiv Disclosure ◽

Hiv Status ◽

Patterns Of Communication ◽

Perinatally Acquired

HIV-related stressors affecting young adults with perinatally acquired HIV (PHIV+) and their siblings include parental and sibling ill-health and death, own ill-health, HIV disclosure, and stigma. Young people with PHIV+ typically share their HIV status with family members. We explored sibling relationships in young people with PHIV+. Ten participants (six females, 17–23 years old) with PHIV+ took part in a semi-structured interview, analysed using Grounded Theory. The data were condensed into three theoretical codes: (1) HIV disclosure in sibling relationship; (2) Patterns of communication about HIV between siblings; and (3) Patterns of coping and support in sibling relationship.

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Who, then what? The need for interventions to help young people with perinatally acquired HIV disclose their HIV status to others

AIDS ◽

10.1097/qad.0000000000000334 ◽

2014 ◽

Vol 28 ◽

pp. S343-S346 ◽

Cited By ~ 15

Author(s):

Michael Evangeli ◽

Caroline Foster

Keyword(s):

Young People ◽

Hiv Status ◽

Perinatally Acquired

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Triangulations of “Motherly Love”: Negotiated Intimacies among Migrant Domestic Workers, Mothers, and Children

Journal of Family Issues ◽

10.1177/0192513x21993858 ◽

2021 ◽

pp. 0192513X2199385

Author(s):

Iris Hoiting

Keyword(s):

Young People ◽

Domestic Workers ◽

Care Work ◽

Men And Women ◽

Gender Expectations ◽

Mothers And Children ◽

Care Relationships ◽

Relational Contexts ◽

Depth Interviews ◽

Migrant Domestic Workers

Persistent economic inequality between men and women, combined with differences in gender expectations and growing inequalities among women globally, has resulted in families “outsourcing” childcare by employing migrant domestic workers (MDWs). While studies have addressed the intimacy and complexity of “mothering” in such contexts, the agentic position of child-recipients of such care have seldom been explored. This article increases our understanding of care-relationships by examining their triangularity among children, MDWs, and mothers in Hong Kong. Drawing on in-depth interviews with young people who grew up with MDWs, alongside interviews with MDWs themselves, this article describes processes through which care work transforms into what Lynch describes as “love labor” in these relational contexts. In these contexts, commodified care from MDWs can develop, through a process of mutual trilateral negotiations, into intimate love-laboring relationships that, in turn, reflect larger dynamics of familial transformation that are endemic to “global cities.”

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Psychotic disorders in young adults with perinatally acquired HIV: a UK case series

Psychological Medicine ◽

10.1017/s0033291720004134 ◽

2020 ◽

pp. 1-7

Author(s):

I. Mallik ◽

T. Pasvol ◽

G. Frize ◽

S. Ayres ◽

A. Barrera ◽

...

Keyword(s):

Mental Health ◽

Young Adults ◽

Young People ◽

Case Series ◽

Psychotic Episode ◽

Published Data ◽

Growing Up ◽

Term Care ◽

Perinatally Acquired

Abstract Background Increasing numbers of children with perinatally acquired HIV (PaHIV) are transitioning into adult care. People living with behaviourally acquired HIV are known to be at more risk of psychosis than uninfected peers. Young adults living with PaHIV face numerous risk factors; biological: lifelong exposure to a neurotrophic virus, antiretroviral medication and immune dysfunction during brain development, and environmental; social deprivation, ethnicity-related discrimination, and migration-related issues. To date, there is little published data on the prevalence of psychotic illness in young people growing up with PaHIV. Methods We conducted a retrospective case note review of all individuals with PaHIV aged over 18 years registered for follow up at a dedicated clinic in the UK (n = 184). Results In total, 12/184 (6.5%), median age 23 years (interquartile range 21–26), had experienced at least one psychotic episode. The presentation and course of the psychotic episodes experienced by our cohort varied from short-lived symptoms to long term illness and nine (75%) appear to have developed a severe and enduring mental illness requiring long term care. Conclusion The prevalence of psychosis in our cohort was clearly above the lifetime prevalence of psychosis in UK individuals aged 16–34 years, which has been reported to be 0.5–1.0%. This highlights the importance of clinical vigilance regarding the mental health of young people growing up with PaHIV and the need to integrate direct access to mental health services within the HIV centres providing medical care.

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24-Month Clinical, Immuno-Virological Outcomes, and HIV Status Disclosure in Adolescents Living With Perinatally-Acquired HIV in the IeDEA-COHADO Cohort in Togo and Côte d'Ivoire, 2015–2017

Frontiers in Pediatrics ◽

10.3389/fped.2021.582883 ◽

2021 ◽

Vol 9 ◽

Author(s):

Marc Harris Dassi Tchoupa Revegue ◽

Unoo Elom Takassi ◽

François Tanoh Eboua ◽

Sophie Desmonde ◽

Ursula Belinda Amoussou-Bouah ◽

...

Keyword(s):

Cote D'ivoire ◽

Côte D’Ivoire ◽

West African ◽

Hiv Disclosure ◽

Cd4 Count ◽

Serostatus Disclosure ◽

Hiv Serostatus ◽

Hiv Serostatus Disclosure ◽

Perinatally Acquired

Background: Adolescents living with perinatally-acquired HIV (APHIV) face challenges including HIV serostatus disclosure. We assessed their 24-month outcomes in relation to the disclosure of their own HIV serostatus.Methods: Nested within the International epidemiologic Database to Evaluate AIDS pediatric West African prospective cohort (IeDEA pWADA), the COHADO cohort included antiretroviral (ART)-treated APHIV aged 10–19 years, enrolled in HIV care before the age of 10 years, in Abidjan (Côte d'Ivoire) and Lomé (Togo) in 2015. We measured the HIV serostatus disclosure at baseline and after 24 months and analyzed its association with a favorable combined 24-month outcome using logistic regression. The 24-month combined clinical immuno-virological outcome was defined as unfavorable when either death, loss to follow-up, progression to WHO-AIDS stage, a decrease of CD4 count >10% compared to baseline, or a detectable viral load (VL > 50 copies/mL) occurred at 24 months.Results: Overall, 209 APHIV were included (51.6% = Abidjan, 54.5% = females). At inclusion, the median CD4 cell count was 521/mm3 [IQR (281–757)]; 29.6% had a VL measurement, of whom, 3.2% were virologically suppressed. APHIV were younger in Lomé {median age: 12 years [interquartile range (IQR): 11–15]} compared to Abidjan [14 years (IQR: 12–15, p = 0.01)]. Full HIV-disclosure increased from 41.6% at inclusion to 74.1% after 24 months. After 24 months of follow-up, six (2.9%) died, eight (3.8%) were lost to follow-up, and four (1.9%) were transferred out. Overall, 73.7% did not progress to the WHO-AIDS stage, and 62.7% had a CD4 count above (±10%) of the baseline value (48.6% in Abidjan vs. 69.0% in Lomé, p < 0.001). Among the 83.7% with VL measurement, 48.8% were virologically suppressed (Abidjan: 45.4%, Lomé: 52.5%, p <0.01). The 24-month combined outcome was favorable for 45% (29.6% in Abidjan and 61.4% in Lomé, p < 0.01). Adjusted for baseline variables, the 24-month outcome was worse in Lomé in those who had been disclosed for >2 years compared to those who had not been disclosed to [aOR = 0.21, 95% CI (0.05–0.84), p = 0.03].Conclusions: The frequency of HIV-disclosure improved over time and differed across countries but remained low among West African APHIV. Overall, the 24-month outcomes were poor. Disclosure before the study was a marker of a poor 24-month outcome in Lomé. Context-specific responses are urgently needed to improve adolescent care and reach the UNAIDS 90% target of virological success.

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24-month clinical, immuno-virological outcomes and HIV status disclosure in adolescents living with perinatally-acquired HIV in the COHADO cohort, in Togo and Côte d’Ivoire, 2015-2017

10.21203/rs.2.15733/v1 ◽

2019 ◽

Author(s):

Marc Harris Dassi Tchoupa Revegue ◽

Elom Takassi ◽

François Tanoh Eboua ◽

Sophie Desmonde ◽

Ursula Belinda Amoussou-Bouah ◽

...

Keyword(s):

Cell Count ◽

Cote D'ivoire ◽

West African ◽

Hiv Disclosure ◽

Virological Suppression ◽

Favorable Outcome ◽

Cd4 Cell Count ◽

Perinatally Acquired ◽

Cd4 Cell

Abstract Background: Adolescents living with perinatally-acquired HIV (APHIV) face challenges including timely disclosure of their HIV-serostatus that was explored in the West-African COHADO cohort. We assessed the 24-month outcomes in COHADO, among APHIV in relation to the disclosure of their own HIV-serostatus.Methods: Nested within the International epidemiologic Database to Evaluate AIDS pediatric West African prospective cohort (IeDEA pWADA), the COHADO cohort included antiretroviral (ART)-treated APHIV aged 10–19 years, enrolled in HIV-care <10 years, in Abidjan (Côte d’Ivoire) and Lomé (Togo) in 2015. A favorable 24-month outcome was defined when combining being retained in care, without progression to WHO-AIDS stage, with CD4 cell count > baseline CD4 (± 10%) and with virological suppression (viral load [VL] <50 copies/mL). We investigated correlates of APHIV favorable 24-month outcome using multivariate logistic regression. Results: Overall, 209 APHIV were included, 51.6% in Abidjan, 54.5% were females. At inclusion, median CD4 cell count was 521/mm3 (IQR[281-757]); only 29.6% had a VL measurement of whom 3.2% in virological suppression. APHIV were younger in Lomé (median age: 12 years (interquartile range [IQR]:11-15) compared to Abidjan (14 years (IQR:12-15, p=0.01). Full HIV-disclosure increased from 41.6% at inclusion to 74.1% after 24 months. After 24 months of follow-up, 6 (2.9%) died, 8 (3.8%) were lost to follow-up, 4 (1.9%) were transferred out. Overall, 73.7% did not progress to WHO-AIDS stage, 62.7% had CD4 count above (± 10%) of the baseline value (48.6% in Abidjan versus 69.0% in Lomé, p<0.001). Among the 83.7% with VL measurements, 48.8% were in virological suppression (Abidjan: 45.4%, Lomé: 52.5%, p<0.01). The 24-month combined outcome was favorable for 45% (29.6% in Abidjan and 61.4% in Lomé, p<0.01). Adjusted on sex, age, a 24-month favorable outcome was not associated with HIV-disclosure status but was significantly higher for APHIV living in Lomé compared to those living Abidjan (adjusted odds ratio =4.41, 95%CI:2.29-8.50). Conclusions: 24-month favorable outcome rates were low among West-African APHIV and differed accross countries. HIV-disclosure frequency improved over time but remained low. Context-specific responses are urgently needed to improve adolescent’s care to reach the UNAIDS 90% target of virological success for those on ART.

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The Development of Generalized Trust among Young People in England

Social Sciences ◽

10.3390/socsci8110299 ◽

2019 ◽

Vol 8 (11) ◽

pp. 299 ◽

Cited By ~ 1

Author(s):

Janmaat

Keyword(s):

Social Learning ◽

Young People ◽

Educational Attainment ◽

Civic Participation ◽

Social Trust ◽

Family Background ◽

Early Adulthood ◽

Late Adolescence ◽

Generalized Trust ◽

Background Factors

This paper explores how generalized trust develops over the life course among young people in England and whether trust is influenced more by family background factors or by conditions in late adolescence and early adulthood. If the latter are important, there may be reason for concern about falling levels of trust as material conditions, particularly regarding housing, have deteriorated for the present generation of young people. The first set of influences are highlighted by a perspective arguing that trust is primarily shaped by conditions in early childhood, while the latter are suggested by the so-called social learning perspective, which claims that people continuously adjust their social trust through interactions with people in different contexts. Analyzing data of the Citizenship Education Longitudinal Survey, the study finds that trust remains quite volatile until the early twenties. It declines between ages 16 and 23 and groups differing in educational attainment, civic participation and housing situation start to drift apart in their levels of trust between these ages. Educational attainment, civic participation and housing, as conditions pertaining to late adolescence and early adulthood, also turn out to have a significant impact on trust at age 23 controlling for trust at age 16. However, while the first two conditions are influenced by trust at age 16, housing (tenure) is not, indicating it is a more exogenous factor. Family background factors are not influential. Not only do these findings support the social learning perspective, they also suggest that poor living conditions depress trust among a significant minority of young people and exacerbate disparities of trust.

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