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Comley-White N1, Potterton J1, Ntsiea V1
1University of the Witwatersrand, Physiotherapy, Johannesburg, South Africa
Background: As the global availability of antiretrovirals for paediatric patients continues to increase, so the body of perinatally HIV-infected adolescents (PHIVA) grows, creating a unique population of people living with a chronic disease. In 2016 there were an estimated 2.1 million adolescents living with HIV, with 84% living in sub-Saharan Africa.
It is well documented that perinatally acquired HIV results in neurological, physical and cognitive developmental delays in children. As they develop into adolescents, there are residual problems in neurocognitive functioning and increased mental health problems. However, there is still a paucity of literature on the physical sequelae of perinatally acquired HIV in adolescents and there has been a clear call for further studies to be done in this area.
As a starting point to establishing what some of the physical sequelae of perinatally acquired HIV may be in the adolescent population, one needs to consider what their experiences are and what they perceive as challenges.
Purpose: This aim of this study was to establish the perceived challenges that PHIVA face with regards to physical sequelae.
Methods: A qualitative study design with semi-structured, individual interviews was conducted. Participants were sourced from an out-patient clinic and research unit for paediatric infectious diseases, in Johannesburg, South Africa. Early and middle phase adolescents (age 10-14 and 15-16 years, respectively) with perinatally acquired HIV were invited to participate. The interviews were audio-recorded and transcribed verbatim. Substantive statements were identified by two separate coders and thematic analysis was done via the general inductive approach. Manifest analysis was used to quantify the data. Field notes were used as an added aspect of triangulation.
Results: After 19 participants were interviewed data saturation was reached. Eleven (57.9%) participants were in early adolescence and eight (42.1%) were in middle adolescence. The mean age was 13.1 ±2.2 years and 12 (63.2%) were female.
Of the 19 participants, only one (5.3%) did not express that they had any challenges. The other 18 participants discussed difficulties with pain (n=10 [52.6%]), endurance (n=9 [47.4%]), fatigue (n=7 [36.8%]), community participation (n=4 [21.1%]), muscle strength and/or motor skills (n=3 [15.8%]), emotional issues (n=2 [10.5%]), and other health issues such as dizziness, forgetfulness, nausea (n=1 [5.3%]).
Conclusion(s): Pain, decreased endurance and fatigue are commonly voiced as challenges for PHIVA. This leads to decreased levels of participation which in turn could lead to other mental and physical health complications.
Implications: Establishing and understanding the perceived challenges that PHIVA face helps to address some of the gaps in knowledge that clinicians experience when working with this vulnerable population. Addressing these challenges through the correct assessment, treatment, referral and education hopefully increases the adolescents' participation, improving their quality of life.
Keywords: Adolescents, perinatal, HIV
Funding acknowledgements: Funding was obtained through the South African Society of Physiotherapy.
It is well documented that perinatally acquired HIV results in neurological, physical and cognitive developmental delays in children. As they develop into adolescents, there are residual problems in neurocognitive functioning and increased mental health problems. However, there is still a paucity of literature on the physical sequelae of perinatally acquired HIV in adolescents and there has been a clear call for further studies to be done in this area.
As a starting point to establishing what some of the physical sequelae of perinatally acquired HIV may be in the adolescent population, one needs to consider what their experiences are and what they perceive as challenges.
Purpose: This aim of this study was to establish the perceived challenges that PHIVA face with regards to physical sequelae.
Methods: A qualitative study design with semi-structured, individual interviews was conducted. Participants were sourced from an out-patient clinic and research unit for paediatric infectious diseases, in Johannesburg, South Africa. Early and middle phase adolescents (age 10-14 and 15-16 years, respectively) with perinatally acquired HIV were invited to participate. The interviews were audio-recorded and transcribed verbatim. Substantive statements were identified by two separate coders and thematic analysis was done via the general inductive approach. Manifest analysis was used to quantify the data. Field notes were used as an added aspect of triangulation.
Results: After 19 participants were interviewed data saturation was reached. Eleven (57.9%) participants were in early adolescence and eight (42.1%) were in middle adolescence. The mean age was 13.1 ±2.2 years and 12 (63.2%) were female.
Of the 19 participants, only one (5.3%) did not express that they had any challenges. The other 18 participants discussed difficulties with pain (n=10 [52.6%]), endurance (n=9 [47.4%]), fatigue (n=7 [36.8%]), community participation (n=4 [21.1%]), muscle strength and/or motor skills (n=3 [15.8%]), emotional issues (n=2 [10.5%]), and other health issues such as dizziness, forgetfulness, nausea (n=1 [5.3%]).
Conclusion(s): Pain, decreased endurance and fatigue are commonly voiced as challenges for PHIVA. This leads to decreased levels of participation which in turn could lead to other mental and physical health complications.
Implications: Establishing and understanding the perceived challenges that PHIVA face helps to address some of the gaps in knowledge that clinicians experience when working with this vulnerable population. Addressing these challenges through the correct assessment, treatment, referral and education hopefully increases the adolescents' participation, improving their quality of life.
Keywords: Adolescents, perinatal, HIV
Funding acknowledgements: Funding was obtained through the South African Society of Physiotherapy.
Topic: Paediatrics; Oncology, HIV & palliative care; Disability & rehabilitation
Ethics approval required: Yes
Institution: University of the Witwatersrand
Ethics committee: Human Research Ethics Committee (medical)
Ethics number: M180226
All authors, affiliations and abstracts have been published as submitted.
