ASHM Report Back
Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
Adolescents and HIV
These are some stand out points from the presentations at APACC covering issues related to HIV +ve youth.
#1 cause of death in 18-25 age group in Sub Saharan Africa is HIV/AIDS
#2 cause of death in 18-25 age group globally is HIV/AIDS.
In Asia, 37% of new infections are in adolescents. HIV +ve adolescents include those infected by MTCT and those infected through sex and IDU.
Rates of mental health diagnoses and neurocognitive issues are high in HIV +ve adolescents. Dr Warren Ng, a psychiatrist from Columbia University, USA has worked with HIV +ve young people for many years. He explained that the grey matter in the brain peaks during early adolescence. This is also a time of increases in gonodal and stress hormones. Mental capacity continues to develop during the 20s. Those most at risk of psychological morbidity include ethnic minorities, those living in poverty, or experiencing psycho-social trauma, substance abuse and inter-generational trauma.
Age appropriate disclosure of HIV status requires teamwork and planning. Transition to adult services needs to be staged and should only be commenced after the young person knows their status. Dr Rangsima Lolekha, shared the data on a cohort of MTCT HIV +ve youth in Thailand. Transition to adult care usually occurs around age 21. The risk of death at this time for these young HIV +ve people is five times that of age matched HIV -ve young people. This vulnerable time is characterised by issues relating to transport, economics, health insurance and less rigorous systems to track continuing care.