Gaitho Douglas
University of Nairobi, Kenya
Title: HIV associated psychosocial adversities and stresses in the lives of adolescents visiting the Comprehensive Care Clinic at Kenyatta National Hospital in Nairobi
Biography
Biography: Gaitho Douglas
Abstract
Globally there are 2.1 million HIV infected adolescents. Mortality due to AIDS related illnesses among adolescents remains unacceptably high, with 120,000 deaths recorded in the year 2013. The trends over the years show that this is increasing, being the only age group with an upward trend in mortality. Kenya is amongst those six countries worldwide that contributes about half of the deaths due to AIDS related illnesses among adolescents. Kenyan adolescents living with HIV face numerous challenges; key amongst them being HIV status disclosure, stigma &discrimination, and adherence to medication. HIV infected adolescents engage in risky sexual behaviors, poly-substance abuse and have been shown to have higher prevalence of depression compared to their HIV uninfected counterparts.
Tracking psychosocial adversities and behavioral outcomes in young people living with HIV provide us with unique insight into developing curative and preventative interventions and allow us to rethink pathways to various services and outreach implementation gaps. Our study highlights HIV associated psychosocial adversities and stresses in the lives of the adolescents visiting the specialist clinic at KNH. We collected extensive survey data mapped on HEADSS domains covering – Health, Education, Alcohol and Drugs, Sexuality functioning of 270 adolescents from ages 10-19 years. While we know our sample participants are in some ways more protected in comparison to others in rural, more remote and in greater poverty context, there are nevertheless critical social determinants and psychosocial adversities that underpin this vulnerable group of young adults. We focus on: food insecurity and household hassles, depression, educational challenges including poor attendance, poor performance, poor social support and attitudes to psychoactive substances, sexuality and disease care that compromise the long term wellbeing of the adolescents. We find that adherence and disclosure rates in the clinic were highly promising however we deliberate upon the profile of young people who are not disclosed to and have challenging family environments. In this sense the paper builds on clusters of participants with vulnerabilities and challenges and discusses how we can address these adversities and stresses in a comprehensive treatment plan