CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

1064 Changes in Suicidality, Depression, and Anxiety After Integrative Mental Health Care in Thai Youth Tavitiya Sudjaritruk 1 , Assawin Narkpongphun 1 , Pradthana Ounchanum 2 , Oramai Mueangmo 1 , Worawan Wongjak 1 , Tanachot Chaito 1 , Pope Kosalaraksa 3 , for the S-BETAH Study Group 1 Chiang Mai University, Chiang Mai, Thailand, 2 Chiang Rai Prachanukroh Hospital, Chiang Rai, Thailand, 3 Khon Kaen University, Khon Kaen, Thailand Background: This study aimed to assess suicidality, depression, and anxiety following the introduction of integrative mental health care into HIV services for Thai youth living with HIV (YLHIV). Methods: A multicenter prospective cohort study was conducted among YLHIV (aged 15-24 years) and age and sex-matched HIV-negative youth in Thailand. Participants were assessed for suicidality, depression and anxiety using the Columbia-Suicide Severity Rating Scale, Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder 7-item (GAD-7) at baseline and 6 months. Significant suicidal risk was defined as suicidal ideation with a specific method, intention, or plan (baseline: lifetime and/or within 1 month; 6-month visit: during the past 6 months), with/without suicide attempts (baseline: lifetime and/or within 3 months; 6-month visit: during the past 6 months). Significant depressive and anxiety symptoms were defined as PHQ-9 and GAD-7 scores of ≥10 at both visits. At each visit, participants demonstrating low suicidal risk or mild depressive or anxiety symptoms received brief mental health counseling by HIV clinic staff, while those with significant suicidal risk or depressive or anxiety symptoms were referred to a psychiatrist for management. Comparisons of participants with mental health symptoms were performed by Chi-square or Fisher’s exact test for YLHIV vs. HIV-negative youth, and McNemar’s test for baseline vs. month 6 visits. Results: Up to 2023, 200 YLHIV (median age 22 years, 59% male, 100% on ART, 86% virally suppressed) and 200 HIV-negative youth (median age 22 years, 59% male) were enrolled. There were no significant differences in mental health outcomes by HIV status at either visit. Compared with their baseline, YLHIV showed a significant decline at 6 months in the proportion of those at significant suicidal risk (4.5 vs. 1.0%; P =0.01), depressive symptoms (12.0 vs. 3.1%; P <0.001), and anxiety symptoms (7.5 vs. 2.1%; P =0.01). Among HIV negative youth, there was a significant decline in the proportion experiencing significant depressive symptoms (7.5 vs. 2.0%, P =0.01); non-significant declines were observed among those at significant suicidal risk (3.0 vs. 0.5%; P =0.06) or anxiety symptoms (3.5 vs. 0.5%; P =0.13) (Table). Conclusions: Providing integrated mental health care in the HIV clinic led to significant declines in suicidality, depression, and anxiety among Thai YLHIV. This model shows potential benefits for addressing the mental health care gap in routine HIV services.

1063 Psychotic Disorders in Young Adults With Perinatally-Acquired HIV: A Multicentre UK Study Indira Mallik 1 , Madeline Robertson 2 , Krupa Ravi 3 , Jessica Glenn 4 , Lauren Nicholls 1 , Sarah Dib 5 , Graham Frize 1 , Sally Hawkins 2 , Sara Ayres 1 , Sarah Fidler 4 , Nadia Ahmed 6 , Elizabeth Hamlyn 2 , Caroline Foster 1 1 Imperial College Healthcare NHS Trust, London, UK, 2 King's College Hospital NHS Foundation Trust, London, UK, 3 NHS Lothian, Edinburgh, UK, 4 Imperial College London, London, UK, 5 UCL Great Ormond Street Institute of Child Health, London, UK, 6 CNWL NHS Trust, London, UK Background: Single cohort UK data suggests an increased lifetime prevalence of psychosis in young people living with perinatally acquired HIV (YPaHIV) compared to age matched peers in the general population (0.5-1.0%), echoed by US data. This is thought to be due to lifelong exposure to a neurotropic virus, neuroinflammation during brain development, and greater experience of adverse life events such as parental death. We examine clinical and psychosocial characteristics associated with psychosis in YPaHIV. Methods: Retrospective case note review of all YPaHIV ≥18years engaged in care at three London youth HIV clinics (n=377) from first attendance to 01/04/2024. We assessed impact of gender, ethnicity, birthplace, prior CDC-C diagnoses, learning disability, parental death, family history of mental health disorders (FHxMHD), and cannabis use on developing psychosis using a multivariate logistic regression model. Results: 27/377 (7.2%) YPaHIV experienced psychosis (YPaHIVP), median age at first episode psychosis (FEP) 21 (IQR 17 - 25) years: current median age 29 (IQR 25 - 31) years, 48.1% male, 81.5% Black, 61.5% born abroad. Age, gender, ethnicity, and birthplace were comparable to YPaHIV without psychosis (YPaHIVwP). Factors significantly associated with psychosis were prior CDC-C diagnoses (OR 3.51, 95% CI 1.17 – 10.49, P =.03), parental bereavement (OR 6.47, 95% CI 1.97 – 21.20, P =.002), cannabis use (OR 7.13, 95% CI 2.45 – 20.78, P <.001) and FHxMHD (OR 23.46, 95% CI 5.51 – 99.82, P <.001). 68.2% YPaHIVwP had VL<200 copies/mL at FEP, in 21/27 (77.8%) no organic cause was identified. All required admission. Median time from FEP to latest follow up (LFU) was 84 (IQR 36 - 108) months; 20/27 (74.1%) had recurrent psychosis, 66.7% remained on antipsychotics, median length of community mental health follow up was 40 (IQR 27 - 81) months. At LFU 85% of YPaHIVP had VL<200 copies/mL compared to 88.6% of YPaHIVwP ( P =.06). 33.3% of YPaHIVP reported self-harm or suicidality compared to 3.7% YPaHIVwP (χ² 22.20, P <.001). Conclusions: In this multi-centre cohort of YPaHIV, psychosis prevalence was 7 times greater than the general age-matched UK population and was associated with high levels of self-harm and suicidality. Clinicians should be aware of increased susceptibility of psychosis in YPaHIV, particularly those with prior CDC-C diagnoses, cannabis use, parental bereavement and FHxMHD. It is imperative to integrate mental health services into HIV care particularly during the vulnerable period of transition.

Poster Abstracts

1065 WITHDRAWN

CROI 2025 342