Addressing Psychosocial Comorbidities among HIV-Infected Youth
For youth who are at risk of HIV infection, normal stressors associated with adolescent development often are exacerbated by poverty, violence, racism, homophobia, homelessness, and child abuse. These factors greatly increase adolescents' risk of becoming substance users and developing mental disorders, which, in turn, can lead to risk-taking behaviors that may expose them to sexually transmitted infections (STIs), including HIV.
HIV-infected adolescents face additional stressors associated with their disease, including loss and bereavement, cycles of wellness and poor health, barriers to care and social services, anxiety, and depression. 3839 Poor coping skills or an inability to adapt to their diagnosis makes them vulnerable to abusing alcohol and other substances.
It should be noted that children infected with HIV are at increased risk of developing central nervous system disease characterized by cognitive, language, motor, and behavioral impairments. Each of these conditions can have a significant impact on an HIV-infected adolescent's ability to learn and on his or her academic and learning achievements. For example, "difficulty remembering things" may be related to psychological distress but also can be a symptom of HIV-associated cognitive impairment. Neurocognitive testing and vocational assessments and testing are appropriate and important interventions.
This section explores the key issues related to HIV-infected adolescents with psychosocial comorbidities, including common elements to look for, the stigma of mental health conditions, the cultural challenges of addressing mental health, successful approaches to care and referrals, the rights of youth with psychosocial comorbidities, and a review of common psychoactive medications used in the treatment of youth with HIV/AIDS.
- Lewis C, Brown S. Coping strategies of female adolescents with HIV/AIDS. ABNF J. 2002 Jul-Aug;13(4):72-7.
- Murphy DA, Moscicki AB, Vermund SH, et al. Psychological distress among HIV(+) adolescents in the REACH study: effects of life stress, social support, and coping. The Adolescent Medicine HIV/AIDS Research Network. J Adolesc Health. 2000 Dec;27(6):391-8.