Dataset Information

School trajectory disruption among adolescents living with perinatal HIV receiving antiretroviral treatments: a case-control study in Thailand.

ABSTRACT:

Background

Adolescents living with perinatal HIV often experience difficult living circumstances that can impact educational achievement and thus their transition to adult life. We explored their school trajectories and evaluated the contribution of perinatal HIV-infection, in Thailand, where education is free and compulsory until the age of 15.

Methods

We used data from the Teens Living with Antiretrovirals (TEEWA) study, a cross-sectional case-control study conducted from 2011 to 2014 in Thailand. Participants were 707 adolescents living with perinatal HIV (ALPHIV, cases) aged 12-19 receiving antiretroviral therapy in 19 hospitals throughout Thailand and 689 HIV-uninfected adolescents (controls) living in the same institutions or, for those living in family settings, randomly selected from the general population and individually matched for sex, age, and place of residence. School trajectory disruption was defined as ?1?year of academic delay or as early school dropout (before 15?years of age). Logistic regression models were used to assess factors independently associated with disrupted school trajectory and to estimate the proportion of school disruption attributable to HIV-infection. We used multivariate imputations by chained equations (MICE) to manage missing data and performed two sensitivity analyses to evaluate the main model's reliability.

Results

The study population's median age was 14.5?years (58% female). School trajectory disruption was experienced by 37% of ALPHIV and 12% of the controls. After adjusting for sociodemographic factors, ALPHIV were 5 times more likely to experience disruption than controls (OR_A =5.2 [3.7-7.2]). About 50% of school trajectory disruption was attributable to HIV-infection. Males and adolescents living in institutions were more likely to experience school trajectory disruption (OR_A =1.8 [1.3-2.4] and OR_A =11.0 [7.7-15.8], respectively). Among ALPHIV, neurocognitive difficulties and growth delay were significantly associated with disruption (OR_A =3.3 [2.1-5.2] and OR_A =1.8 [1.3-2.6], respectively). For those living in families, disruption was also associated with having a caregiver who had less than a secondary-level education (OR_A =2.1 [1.1-3.9]) or having experienced stigmatization (OR_A =1.9 [1.2-3.1]).

Conclusions

HIV and contextual factors combine to aggravate the educational disadvantage among ALPHIV. The impact of this disadvantage on their life prospects, especially regarding access to higher education and professional achievement, should be further explored.

SUBMITTER: Merville O

PROVIDER: S-EPMC7818931 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

School trajectory disruption among adolescents living with perinatal HIV receiving antiretroviral treatments: a case-control study in Thailand.

Merville Ophélie O Puangmala Patcharee P Suksawas Pranee P Kliangpiboon Woranut W Keawvilai Waraporn W Tunkam Chorkanikar C Yama Suvimon S Sukhaphan Usa U Sathan Somporn S Marasri Siriporn S Rolland-Guillard Louise L Sirirungsi Wasna W Le Cœur Sophie S

BMC public health 20210121 1

<h4>Background</h4>Adolescents living with perinatal HIV often experience difficult living circumstances that can impact educational achievement and thus their transition to adult life. We explored their school trajectories and evaluated the contribution of perinatal HIV-infection, in Thailand, where education is free and compulsory until the age of 15.<h4>Methods</h4>We used data from the Teens Living with Antiretrovirals (TEEWA) study, a cross-sectional case-control study conducted from 2011 t ...[more]

PMID: 33478442

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Project description:BackgroundExisting studies have suggested decreased adherence and rebound in mortality in perinatally HIV-infected adolescents receiving antiretroviral therapy (ART) as compared to adults and young children.MethodsWe used both quantitative and qualitative approaches to identify factors influencing adherence among perinatally infected adolescents in Thailand. We analyzed data from 568 pairs of perinatally infected adolescents (aged 12-19) and their primary caregivers in the Teens Living With Antiretrovirals (TEEWA) study, a cross-sectional survey conducted in 2010-2012. We also conducted 12 in-depth interviews in 2014 with infected adolescents or their primary caregivers to elicit experiences of living with long-term ART.ResultsFrom the quantitative analysis, a total of 275 (48.4%) adolescents had evidence of suboptimal adherence based on this composite outcome: adolescents self-reported missing doses in the past 7 days, caregiver rating of overall adherence as suboptimal, or latest HIV-RNA viral load ≥1000 copies/ml. In multivariate logistic regression analysis, younger age, having grandparents or extended family members as the primary caregiver, caregiver-assessed poor intellectual ability, having a boy/girlfriend, frequent online chatting, self-reported unhappiness and easiness in asking doctors questions were significantly associated with suboptimal adherence. From the in-depth interviews, tensed relationships with caregivers, forgetfulness due to busy schedules, and fear of disclosing HIV status to others, especially boy/girlfriends, were important contributors to suboptimal adherence. Social and emotional support and counseling from peer group was consistently reported as a strong adherence-promoting factor.ConclusionOur findings highlight unique barriers of ART adherence among the perinatally infected adolescents. Future interventions should be targeted at helping adolescents to improve interpersonal relationships and build adaptive skills in recognizing and addressing challenging situations related to ART taking.

Project description:A lifestyle with erratic eating patterns and habits predisposes youngsters to obesity. Through a two-phase feasibility study among Indian students living in the Delhi area, we longitudinally examined the following: (1) the daily eating-fasting cycles of students (N = 34) in school and college using smartphones as they transition from high school (aged 13-15 years; nIX = 13) to higher secondary school (HSSS; 16-18 years; nXII = 9) to their first year (FY) of college (18-19 years; nFC = 12); and (2) daily activity-rest cycles and light-dark exposure of 31 higher secondary school students (HSSS) using actigraphy. In phase 1, students' food data were analyzed for temporal details of eating events and observable differences in diet composition, such as an energy-dense diet (fast food (FF)), as confounding factors of circadian health. Overall, the mean eating duration in high school, higher secondary and FY college students ranged from 14.1 to 16.2h. HSSS exhibited the shortest night fasting. Although FY college students exhibited the highest fast food percentage (FF%), a positive correlation between body mass index (BMI) and FF% was observed only among HSSS. Furthermore, the body weight of HSSS was significantly higher, indicating that FF, untimely eating and reduced night fasting were important obesity-associated factors in adolescents. Reduced night fasting duration was also related to shorter sleep in HSSS. Therefore, food data were supplemented with wrist actigraphy, i.e., activity-rest data, in HSSS. Actigraphy externally validated the increased obesogenic consequences of deregulated eating rhythms in HSSS. CamNtech motion watches were used to assess the relationship between disturbed activity cycles of HSSS and other circadian clock-related rhythms, such as sleep. Less than 50% of Indian HSSS slept 6 hours or more per night. Seven of 31 students remained awake throughout the night, during which they had more than 20% of their daily light exposure. Three nonparametric circadian rhythm analysis (NPCRA) variables revealed circadian disruption of activity in HSSS. The present study suggests that inappropriate timing and quality of food and sleep disturbances are important determinants of circadian disruptions in adolescents attending school.

Project description:People living with HIV who are on antiretroviral treatment are at increased risk of developing premature cardiovascular disease. Children with perinatal HIV infection (PHIV) have survived through their adolescence and are entering adulthood. We determined the prevalence of metabolic syndrome, abnormal biochemical markers, and characterized body composition parameters in youth living with perinatal HIV infection. This cross-sectional study was conducted at the Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand from December 2017 to February 2018. PHIV-youths between 15 <25 years of age who were receiving ART were enrolled. Data collection included ART-related history, blood pressure, and anthropometric measurements. Body composition including android, gynoid fat mass, and total body fat were measured by dual-energy X-ray absorptiometry. Fasting blood was drawn to test for lipid profile, glucose, and high sensitivity c-reactive protein (hsCRP). One hundred and twenty PHIV-youths (48% female) were enrolled. Their mean age and the median duration on ART were 20.3 (SD2.6) and 14.1 (IQR 10.4-14.9) years, respectively; 76 (63%) were on first-line non-nucleoside reverse transcriptase inhibitors-based regimens. Thirty-three (28%), 74 (62%), and 13 (11%) of PHIV-youths were underweight (BMI < 18.5 kg/m2), normal (BMI 18.5-24.9 kg/m2), and overweight (BMI ≥ 25.0 kg/m2), respectively. The prevalence of metabolic syndrome was 10.6% (95%CI 5.0-16.0). Seventy-six of 113 (67.3%) of PHIV-youths had lipid alteration; the most prevalent types being low HDL (46.9%) and increased triglycerides (27.4%). Overall 43 (35.9%) had increased hsCRP (16.7% with immediate and 19.2% with high risk for CVD). Females had significantly higher percentage of android and gynoid fat, but lower Android to gynoid ratio (AGR) compared to males. There were 77%, 31%, and 21% of PHIV-youths in the overweight, normal weight, and underweight group with AGR in tertile 3, respectively. In conclusion, we documented presence of metabolic syndrome in 10.6% of PHIV-youths on ART. Increase AGR representing abdominal obesity was detected even in youths with normal BMI or underweight.

Dataset Information

School trajectory disruption among adolescents living with perinatal HIV receiving antiretroviral treatments: a case-control study in Thailand.

Background

Methods

Results

Conclusions

Publications

School trajectory disruption among adolescents living with perinatal HIV receiving antiretroviral treatments: a case-control study in Thailand.

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