Online Program

Rwandan Youth With HIV: Impact of Mental Health on Adherence

Tuesday, November 3, 2015 : 12:50 p.m. - 1:10 p.m.

Mardge H. Cohen, MD, Departments of Medicine/CORE Center at John H. Stroger Jr Hospital of Cook County, Cook County Health & Hospital System, Chicago, IL
Geri Donenberg, PhD, Department of Medicine and School of Public Health, University of Illinois at Chicago, Chicago, IL
Mary Fabri, PsyD, Independent Consultant, Chinle, AZ
Charles Ingabire, MPH, Research Department/ Kigali Imbereheza Project, WE-ACTx For Hope, Kigali, Rwanda
Sabin Nsanzimana, MD, Rwanda Biomedical Center, Kigali, Rwanda
Jean-Luc Nkurikiyimfura, MD, HIV Clinic, Central Hospital University of Kigali, Kigali, Rwanda
Background: Youth with HIV in subSaharan Africa face multiple barriers to adhering to antiretroviral therapy. In Rwanda, HIV+ youth have the added challenge of living in a post-conflict society following the genocide. The Kigali Imbereheza Project (KIP) is evaluating an enhanced Trauma Informed Cognitive Behavioral Therapy intervention to increase adolescent medication adherence among in Rwanda. This paper presents baseline data on youth mental health and adherence.

Methods: To date, 159 14-21 year-old (M=17) males (49%) and females (51%) were recruited from the two main HIV care providers in Kigali. Youth completed ACASI baseline assessments of their mental health and adherence. 26% reported being orphans, 95% reported being poor, and 27% reported physical abuse. Over the past month, 35% endorsed good or excellent adherence to antiretroviral, with 25% reporting no missed doses and 28% missing 1 day of anti-retrovirals.

Results: Higher rates of anxiety/depression and more traumatic events were associated with missing at least one ART dose (p <.01), and more reported traumatic events and physical abuse were linked to less likelihood of taking ART as prescribed (p<.01). Importantly, greater resiliency and self-esteem were associated with better adherence (p<.01).

Conclusions: Increasing adherence among HIV infected youth is a global public health priority. Findings underscore the role of mental health in adherence. HIV care must attend to youth trauma, anxiety and depression to improve adherence.

Learning Areas:

Chronic disease management and prevention
Social and behavioral sciences

Learning Objectives:
Describe mental health concerns for HIV-positive Rwandan youth

Keyword(s): Child/Adolescent Mental Health, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the co-principal investigator on the federally funded study to increase medication adherence among HIV+ youth.I am a MD with over 15 years experience in the field of HIV/AIDS research, specifically around issues pertaining to youth.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4236.0: Women and HIV/AIDS