Mental Health in Children, Adolescents, and Youths Living with Perinatally Acquired HIV: At the Crossroads of Psychosocial Determinants of Health

Álvaro Vázquez-Pérez; Carlos Velo; Luis Escosa; Teresa García-Lopez; Jose I Bernardino; Eulalia Valencia; Rafael Mican; María José Mellado; Talía Sainz

doi:10.3390/children10020405

Mental Health in Children, Adolescents, and Youths Living with Perinatally Acquired HIV: At the Crossroads of Psychosocial Determinants of Health

Children (Basel). 2023 Feb 18;10(2):405. doi: 10.3390/children10020405.

Authors

Álvaro Vázquez-Pérez¹, Carlos Velo², Luis Escosa^{3

4}, Teresa García-Lopez³, Jose I Bernardino^{4

5}, Eulalia Valencia⁵, Rafael Mican⁵, María José Mellado^{3

4}, Talía Sainz^{3

4

6}

Affiliations

¹ Department of Pediatrics, Virgen de las Nieves University Hospital, 18014 Granada, Spain.
² Gregorio Marañón Health Research Institute (IISGM), 28007 Madrid, Spain.
³ Department of Pediatrics, Infectious and Tropical Diseases, La Paz University Hospital and La Paz Research Institute (IdiPAZ), 28046 Madrid, Spain.
⁴ Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), C. de Melchor Fernández Almagro, 3, 28029 Madrid, Spain.
⁵ HIV Unit, Infectious Diseases and Internal Medicine Department, La Paz University Hospital and La Paz Research Institute (IdiPAZ), 28046 Madrid, Spain.
⁶ Facultad de Medicina, Universidad Autónoma de Madrid, C. Arzobispo Morcillo, 4, 28029 Madrid, Spain.

Abstract

Here, we aim to describe mental health (MH) in a cohort of children, adolescents, and young adults living with perinatally acquired HIV (PHIV) in Spain and explore the treatment gap for mental disorders. We also aim to analyze the potential association between MH issues to psychosocial risk factors (PSRFs) and identify management priorities. We conducted a descriptive transversal study that included all cases of PHIV under follow-up in a reference hospital in Madrid. The study included patients undergoing follow-up in the pediatric outpatient clinic and youths transferred from pediatric to adult care units after 1997. Epidemiological, clinical, immunovirological, and treatment-related data were collected, including PSRF and adverse childhood experiences (ACEs). Of the 72 patients undergoing follow-up, 43 (59.7%) had already been transferred to the adult outpatient clinic. The patients' median age was 25 years (IQR 18-29), and 54.2% were women. Most patients were undergoing treatment (94.6%) and were virologically suppressed (84.7%). Although MH issues were present in 30 patients (41.7%), only 17 (56.7%) had been referred for evaluation to the Department of Mental Health, and only 9 (30%) had received a MH diagnosis. PSRFs were common (32% of participants had at least one PSRF) and were associated with MH issues and adherence issues (all p < 0.05). A multidisciplinary approach to address the psychological factors and social determinants of health is urgently needed, particularly during important life development stages, such as adolescence.

Keywords: HIV; adolescents; children; mental health; psychosocial factors; vertical transmission.

Grants and funding

This study was supported by a grant (PI20/01490) from the Instituto de Salud Carlos III of Spain, co-financed by the European Development Regional Fund (‘A Way to Achieve Europe’). The Pediatric Cohort of the Spanish National AIDS Network (CoRISpe), is supported by Instituto de Salud Carlos III, Spanish Health Ministry (Grant no. RD16/0025/0017). C.V. was funded by a grant from the Spanish Ministry of Science and Innovation—Instituto de Salud Carlos III- Predoctoral fellowship (Grant no. FI20/000292) T.S. was funded by a grant from the Spanish Ministry of Science and Innovation—Instituto de Salud Carlos III (Bolsa de Ampliación de Estudios BA21/00022) and Feder-FFE.