New Challenges for a Young Generation: Understanding Medication Adherence and Mental Health Impairments Among South African Perinatally Infected Youth in Early Adolescence
Method: This paper draws on baseline data from a small-scale NIH-funded longitudinal pilot study of perinatally infected seropositive youth in KwaZulu Natal, South Africa (n=66). The sample consists of boys (n=33) and girls (n=32) ages 10-13 years old (M=11.57, SD=1.2). Almost half lived with their mothers (47%), while others resided with relatives (father, aunt/uncle, grandparent). Their knowledge of their HIV diagnosis ranged from one week to 13 years. Multivariate analyses were used to examine the relationship between youth medication adherence, parent support in medication management and youth mental health challenges and prosocial strengths. Standardized instruments, including the Strengths and Difficulties Questionnaire (Goodman, Meltzer, and Bailey, 1998) and the VUKA Adherence Questionnaire (Mellins et al., 2010) were used.
Results: Youth presented with serious mental health challenges (62% met criteria for impairments in behavioral and emotional functioning). Parental medication monitoring was positively associated with youth ART adherence. Yet, youth conduct related difficulties significantly interfered with parental medication supports, while youth prosocial behavior was significantly associated with obtaining parental help with taking ART medications.
Implications: Evidence-informed psychosocial interventions are needed to address youth health and behavioral outcomes in South Africa and globally. Family-focused models may be of particular utility and impact. Integrating sustainable and effective interventions can help guide this young cohort's navigation through challenging developmental stages, reducing compromised behavioral health and transmission risk in complex real-world settings.