screening for depression and anxiety All 26 adolescents retained at 6 months achieved viral suppression Anticipatory screening and active management of mental health problems from the outset at ARV initiation in horizontally infected adolescents appears to be important in supportin ID: 935958
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29%abnormal scores inscreening for depression and anxietyAll 26 adolescents retained at 6 months achieved viral suppressionAnticipatory screening and active management of mental health problems from the outset at ARV initiation in horizontally infected adolescents appears to be important in supporting future ARV adherence and retention.
Lessons learned from impact of mental health care integration into
HIV adolescent same day antiretroviral services on drug adherence and care retention in Bangkok, Thailand
Authors:C. Saisaengjan1 W.N. Songtaweesin1, P. Thisayakorn2, P. Deeklum1, S. Lonhin1, T. Theerawit1, P. Wongharn1, R. Ramautarsing3, T. Chinbunchorn3, S. Amatavete3, N. Phanuphak3, T. Puthanakit1, 4, CE-PID - TRC Adolescent Study Team 1Chulalongkorn University, Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Bangkok, Thailand, 2Chulalongkorn University, Department of Psychiatry, Faculty of Medicine, Bangkok, Thailand, 3Thai Red Cross AIDS Research Center, PREVENTION, Bangkok, Thailand, 4Chulalongkorn University, Department of Pediatrics, Faculty of Medicine, Bangkok, Thailand
PRESENTED AT THE 23
RD INTERNATIONAL AIDS CONFERENCE (AIDS 2020) | 6-10 JULY 2020
The paintings
: ‘N’, an adolescent living with HIV and psychotic depressionContact person: Chutima.Sai@chula.ac.th
BACKGROUND
In an era of same day antiretroviral treatment (SDART) initiation, novel service provision strategies are needed to address psychosocial needs of newly diagnosed HIV-infected youth
. We looked at lessons learned from implementation of mental health care integration to HIV services for adolescents with horizontally acquired HIV initiating SDART in Thailand.
DESCRIPTION
Between February 2018 and December 2019, 42 adolescents aged between 13-24 years newly diagnosed with HIV at the Thai Red Cross Anonymous HIV Testing Center were initiated on SDART.They were referred to continue care at the Integrated Youth Care Clinic (IYCC) at King Chulalongkorn Memorial Hospital. The IYCC provided personal case managers who performed mental health screening at baseline, coordinated care between IYCC and psychiatry, and home visitations.
BASELINE CHARACTERISTICSAt baseline, median age was 17 years (IQR 16-19)Median CD4 count was 311 cells/mm336 (86%) were MSM8 (19%) reported substance use (ketamine or amphetamines)12 (29%) had abnormal scores and/or suicidal ideation*11 (26%) were diagnosed with mental health disorders (8 depression, 1 gender dysphoria, 1 generalized anxiety disorder, 1 adjustment disorder).*Screening for depression was done using the patient health questionnaire-9 (PHQ-9), and for anxiety using the generalized anxiety disorder 7-item (GAD-7) scale. Abnormal scores were defined as ≥9 for PHQ-9 and ≥11 for GAD-7
CONCLUSIONS
Anticipatory screening and active management of mental health problems from the outset at ARV initiation in horizontally infected adolescents appears to be important in supporting future ARV adherence and retention.
Preparation of this adolescent population for future successful transition to adult services is needed.
LESSONS LEARNEDPsychosocial issues identified included: family issues, gender stigma, HIV stigma and financial problems.12 (29%) had abnormal scores and/or suicidal ideation received counselling from a clinical psychologist and were linked to psychiatric care within 1 monthEight received medication with counselling, and 4 received counselling alone. All were offered peer support, disclosure support, self-esteem building group activities, and financial support for psychiatric care and educational fees as needed. At 6 months, retention was 26/30 (87%), 2/30 (7%) had transitioned to adult services, and 2/30 (7%) were lost to follow-up. All 26 adolescents retained at 6 months achieved viral suppression.