title: Disease disclosure, treatment adherence, and behavioural profile in a cohort of vertically acquired HIV-infected adolescents. NeuroCoRISpeS study.
abstract: Advances in care and antiretroviral treatment, improved life expectancy and quality of life in children with perinatally-acquired human immunodeficiency virus (HIV) infection. There is increasing interest in the chronic effects of growing up with HIV. The aim of this study was to assess the psychosocial, emotional and behavioural functioning in a cohort of perinatally-acquired HIV-infected adolescents. Data were obtained through semi-structured interviews and the Strengths and Difficulties Questionnaire (SDQ) for emotional and behavioural disorders screening.
  
  
  RESULTS
  A total of 95 patients (58% women) were assessed with a median age of 15 years (11-19.1) and a median age at diagnosis of 1.7 years (0-12.2). The median CD4 count, at the inclusion, was 626 cells/mm(3) (132-998), with 34% (10-52%). Viral load was <50 copies/ml in 72% of patients. Eighty-one per cent knew their diagnosis and optimal adherence was achieved in 53%. Passive coping was reported in 58.4% of the adolescents. Only 7.7% of teenagers had a complete and adequate knowledge of their disease and only 18.2% had shared it with their friends. Six unwanted pregnancies occurred (11% of women). Most of them (90%) attended school but 60% had been held back one or more school years. Overall, SDQ scored a risk of behavioural and emotional problems in 24.5%. The report of behaviours associated with hyperactivity was high in 14.9% of the population and borderline in 18.1%. Adolescents with encephalopathy accounted for 44% of those whose total scores fell in either the abnormal and borderline ranges for emotional difficulties (p = .038).
  
  
  CONCLUSIONS
  Perinatally-acquired HIV-infected adolescents showed significant psychosocial and behavioural health risks that should bring attention to prevention and health care programmes. An earlier disclosure to children could favour a better psychological adjustment and a better treatment adherence. Future studies are needed to assess the relationship between vertically acquired HIV-infection and hyperactivity.
authors: a Pediatrics HIV and Infectious Disease Department , Hospital Doce de Octubre , Madrid , Spain.
authors: Gabriela
authors: G
authors: Medin
authors: a Pediatrics HIV and Infectious Disease Department , Hospital Doce de Octubre , Madrid , Spain.
authors: Cristina
authors: C
authors: García-Navarro
authors: b Pediatrics Infectious Disease Department , Hospital General Universitario Gregorio Marañón , Madrid , Spain.
authors: Marisa
authors: M
authors: Navarro Gomez
authors: c Pediatrics Department , Hospital Clínico , Madrid , Spain.
authors: Jose Tomás
authors: JT
authors: Ramos Amador
authors: d Pediatrics HIV and Infectious Diseases Department , Hospital La paz , Madrid , Spain.
authors: María José
authors: MJ
authors: Mellado
authors: e Lab. Inmuno-biología molecular. Spanish HIV BioBank , Hospital General Universitario Gregorio Marañón , Madrid , Spain.
authors: Santiago
authors: S
authors: Jimenez
authors: e Lab. Inmuno-biología molecular. Spanish HIV BioBank , Hospital General Universitario Gregorio Marañón , Madrid , Spain.
authors: María Angeles
authors: MA
authors: Muñoz-Fernández
authors: a Pediatrics HIV and Infectious Disease Department , Hospital Doce de Octubre , Madrid , Spain.
authors: Pablo
authors: P
authors: Rojo Conejo
authors: b Pediatrics Infectious Disease Department , Hospital General Universitario Gregorio Marañón , Madrid , Spain.
authors: Jesús
authors: J
authors: Saavedra
authors: d Pediatrics HIV and Infectious Diseases Department , Hospital La paz , Madrid , Spain.
authors: Milagros
authors: M
authors: García Hortelano
authors: f Pediatrics Department , Hospital Universitario de Getafe , Madrid , Spain.
authors: Sara
authors: S
authors: Guillén
authors: a Pediatrics HIV and Infectious Disease Department , Hospital Doce de Octubre , Madrid , Spain.
authors: María Isabel
authors: MI
authors: González-Tomé
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D011788:Quality of Life; D057545:Social Stigma; D012959:Socioeconomic Factors; D013030:Spain; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D019562:Viral Load; D055815:Young Adult
keywords: HIV; adherence; adolescence; disclosure; psychosocial; vertical transmission