CROI 2020 Abstract eBook

Abstract eBook

Poster Abstracts

Results: Of 592 participants included in the analysis, 308 (52%) were female, 235 (40%) were 10-17 years old and 355 (60%) had undetectable viral load. The prevalence of depression was 16%. Regarding substance use in previous 3 months, 338 (57%) used alcohol, 170 (29%) tobacco, and 110 (19%) illicit drugs. Non-adherence in previous week was reported by 213 (36%) participants. Females were more likely to report depression (adjusted odds ratio (aOR) 2.9, 95% CI 1.6–5.1) and less likely to report illicit drug use (aOR 0.34, 95%CI 0.2–0.7) than males. Alcohol use in previous 3 months was associated with the use of tobacco (aOR 10.4, 95%CI 4.6–23.9) and illicit drugs (aOR6.9, 95%CI 1.8–26.4). Tobacco was the only substance associated with non-adherence (Table). Conclusion: The prevalence of substance use was higher than found among CCASAnet adults in a previous analysis. Youth reporting alcohol and tobacco use should be screened for illicit drug use. Although alcohol and illicit drugs were not associated with ART adherence, youth using these substances may be at increased risk for mortality related to violence and traffic accidents - which are the main cause of death in many Latin American countries. Further studies and interventions are needed.

and uninfected (YHUU) in Asia, as well as the relationship of depression and stigma. Methods: Data from the PREDICT Resilience longitudinal cohort study of 482 Cambodian and Thai adolescents aged ≥ 10 years (223 YPHIV, 117 YPHEU and 142 YHUU) were analyzed. Depression screening was performed annually using the Child Depression Inventory (CDI) for those aged 10-15 years and the Center for Epidemiological Studies Depression Scale (CES-D) for those aged 15-24 years. PDS were defined as CDI or CES-D scores ≥ 16 in ≥ 2 consecutive visits. Executive function (EF) was measured annually by the Delis-Kaplan Executive Function System (D-KEFS) verbal and design fluency tests; self-reported stigma was identified at annual interview. We compared the prevalence of PDS by PHIV status and adolescent time period (early, mid-, and late adolescence). Generalized estimating equations with Poisson regression were used to identify associations of EF, age group, and stigma experiences with persistent depressive symptoms. Results: Between July 2015 to July 2019, 482 adolescents completed baseline evaluations; median age was 13.8 years (IQR=11.8-16.1). Prevalence of PDS was highest among YPHIV (23.8%), followed by YPHEU (17.9%) and YHUU (14.1%) (p=0.09). Adjusted incidence rate ratios (aIRR) of PDS were 2.05 (95% CI of aIRR=1.03-4.07) and 2.66 (95% CI=1.21-5.85) among adolescents aged 15-17 and 18-24 years compared to those 13-15 years, respectively. Across 144 weeks of follow-up, adolescents with PDS performed worse on measures of EF compared to those without symptoms (p<0.001). Among the 223 YPHIV youth, stigma at baseline (26%) was associated with PDS (p=0.045). Conclusion: Persistent depressive symptoms were present among all 3 groups of youth in Cambodia and Thailand, and are more likely as youth age towards young adulthood. Transition to adult responsibilities and self-care, especially for YPHIV, may be complicated by associated psychosocial and EF challenges. Comprehensive mental health diagnosis and care should be integrated into HIV services. 833 DEPRESSION, SUBSTANCE USE, AND ADHERENCE AMONG LATIN AMERICAN YOUTH LIVING WITH HIV Daisy Machado 1 , Raquel B. De Boni 2 , Fernanda Maruri 3 , Vanessa A.Rouzier 4 , Brenda Crabtree-Ramírez 5 , Denis Padgett 6 , Fernando A.Mejia 7 , M. Fernanda Rodriguez 8 , Jorge Pinto 9 , Catherine McGowan 3 1 Universidade Federal de São Paulo, Sao Paulo, Brazil, 2 Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro. Brazil, 3 Vanderbilt University, Nashville, TN, USA, 4 GHESKIO, Port-au-Prince, Haiti, 5 Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, 6 Instituto Hondureño de Seguridad Social, Tegucigalpa, Honduras, 7 Universidad Peruana Cayetano Heredia, Lima, Peru, 8 Fundación Arriarán, Santiago, Chile, 9 Universidade Federal de Minas Gerais, Belo Horizonte, Brazil Background: Adolescents and young adults living with HIV are situated within a dynamic confluence of behavioral, developmental, and care transitions that pose unique challenges to provide optimal healthcare. Depression and substance use may impact antiretroviral therapy (ART) adherence, but data from Latin America are scarce. We evaluated the prevalence and factors associated with depression, substance use, and self-reported adherence among youth in HIV care. Methods: Cross-sectional study including adolescents (10 to <18 years) and young adults (18 to <25 years) on ART for ≥6 months within the Caribbean, Central and South America network for HIV epidemiology (CCASAnet) in Brazil, Chile, Haiti, Honduras, Mexico and Peru. Individuals were screened for depression (Patient Health Questionnaires,PHQ- 2/9/A), substance use (The Alcohol, Smoking and Substance Involvement Screening Test) and ART adherence (The Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol). Multivariable logistic regression models were used to evaluate factors associated with each outcome.

Poster Abstracts

834 SUBSTANCE USE IN PERINATALLY INFECTED AND SAME-AGE HIV– ADOLESCENTS IN SOUTH AFRICA Kirsty Brittain 1 , Landon Myer 1 , Nicole Phillips 1 , Heather Zar 1 , Dan Stein 1 , Jackie Hoare 1 1 University of Cape Town, Cape Town, South Africa Background: Experimentation with substances is common among adolescents, but there are few longitudinal data exploring the prevalence among perinatally-infected adolescents living with HIV (PHIV+) in sub-Saharan Africa, including comparisons with HIV- adolescents. Methods: The Cape Town Adolescent Antiretroviral Cohort follows PHIV+ and age- and gender-matched HIV- adolescents in South Africa. Self-reported substance use was assessed annually, and a 6-panel urine toxicology screen tested for common substances (marijuana, methaqualone, cocaine, methamphetamine, MDMA, opiates) at enrolment and after 36 and 48 months of follow-up; HIV viral load (VL) was measured annually. Using repeated measures, we describe substance use during pre-adolescence (ages 9-11 years), early (12-14 years) and middle-late adolescence (15-19 years). Results: A total of 515 PHIV+ (median age at enrolment: 11.9 years; 49% female) and 110 HIV- adolescents (11.7 years; 55% female) contributed 1491 toxicology screens over a median of 4 years. Overall, 5.5% of tests were positive. The most commonly used substance was marijuana (95% of all positive tests), followed by methaqualone/mandrax (17%) and methamphetamine (9%). Among females, neither age nor HIV status was associated with a positive test. Among males, older age was strongly associated with a positive screen (p<0.001); male PHIV+ were significantly less likely to screen positive across study visits after adjusting for age (aOR: 0.15 [0.04-0.60]; Figure A). Self-report of ever using alcohol was common: among PHIV+, report of use increased from 3% in pre-adolescence to 7% and 29% in early and middle-late adolescence; with levels of use even higher

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