Me-sex relationships. Perinatally- versus horizontally-infected adolescents In 2007, it was estimated that

Me-sex relationships. Perinatally- versus horizontally-infected adolescents In 2007, it was estimated that up to 90 of all children with HIV aged under 15 years had become infected through their mothers during pregnancy, labour, delivery, or via breastfeeding [48]. There have been significant reductions in perinatalAdejumo OA et al. Journal of fpsyg.2017.00209 the International AIDS Society 2015, 18:20049 http://www.jiasociety.org/index.php/jias/article/view/20049 | http://dx.doi.org/10.7448/IAS.18.1.transmission of HIV in both well-resourced and resourcelimited settings in recent years [1,49] and improved treatment with combination ART has resulted in large numbers of children surviving into adolescence and beyond [50?3]. However, Duvoglustat site perinatally-infected children who reach adolescence may have experienced chronic immunosuppression, which has been associated with impaired neurocognitive development and delayed sexual maturation [54,55]. They are also at risk of long-term ART adverse effects, including hyperlipidaemia, cardiovascular disease and renal impairment [50,56,57], and may experience reduced efficacy of combined oral contraceptive pills due to interactions with ARTs [58]. In addition to the large population of perinatally-infected adolescents, a substantial number acquire HIV through other routes such as sex and injecting drug use. Among young people aged 10 to 24 years all over the world, most HIV infections are believed to be sexually acquired [59]. HIVinfected adolescents in several parts of sub-Saharan Africa are unaware of their HIV status [21,49], and lack access to counselling, testing and treatment needed to prevent onward transmission [49,60]. Even where such facilities are available, adolescents may fall below the legal age of independent consent for these services [61]. Mortality and morbidity among HIV-infected youth in sub-Saharan Africa In contrast to the significant decline in global deaths from AIDS-related causes over the past decade [1,18,49], deaths among adolescents have increased during this period [62,63]. HIV currently ranks second among global causes of adolescent deaths [64], and one study found a nearly 50 increase in adolescent AIDS-related deaths between 2005 and 2012 [12]. This increase has occurred predominantly in the African region. Neurocognitive deficits and psychiatric symptoms are complications among individuals of all jir.2014.0227 ages with HIV and have implications for adherence. Several buy 1-Deoxynojirimycin studies conducted in well-resourced settings have reported a high prevalence of neurocognitive and psychiatric morbidity among HIV-infected adolescents compared to those uninfected [65?7]. In addition, emotional and behavioural problems are more frequently observed among HIV-infected adolescents, compared to normative data or comparison groups [68]. Rates, however, vary across studies, with some researchers reporting no difference between infected and uninfected groups, or even more psychological problems among uninfected adolescents than those infected [68]. Most research into neuropsychological outcomes of HIV/AIDS in sub-Saharan Africa has focused on adult [69?4] or paediatric [75?8] populations, and there is a need for adolescent studies in this area. Adherence to ART Adherence to ART in HIV-infected individuals is a strong determinant of disease outcome. Interventions which improve adherence are associated with successful viral suppression, reduced risk of opportunistic infections and prevention of drug resistance [79?1]. Although ad.Me-sex relationships. Perinatally- versus horizontally-infected adolescents In 2007, it was estimated that up to 90 of all children with HIV aged under 15 years had become infected through their mothers during pregnancy, labour, delivery, or via breastfeeding [48]. There have been significant reductions in perinatalAdejumo OA et al. Journal of fpsyg.2017.00209 the International AIDS Society 2015, 18:20049 http://www.jiasociety.org/index.php/jias/article/view/20049 | http://dx.doi.org/10.7448/IAS.18.1.transmission of HIV in both well-resourced and resourcelimited settings in recent years [1,49] and improved treatment with combination ART has resulted in large numbers of children surviving into adolescence and beyond [50?3]. However, perinatally-infected children who reach adolescence may have experienced chronic immunosuppression, which has been associated with impaired neurocognitive development and delayed sexual maturation [54,55]. They are also at risk of long-term ART adverse effects, including hyperlipidaemia, cardiovascular disease and renal impairment [50,56,57], and may experience reduced efficacy of combined oral contraceptive pills due to interactions with ARTs [58]. In addition to the large population of perinatally-infected adolescents, a substantial number acquire HIV through other routes such as sex and injecting drug use. Among young people aged 10 to 24 years all over the world, most HIV infections are believed to be sexually acquired [59]. HIVinfected adolescents in several parts of sub-Saharan Africa are unaware of their HIV status [21,49], and lack access to counselling, testing and treatment needed to prevent onward transmission [49,60]. Even where such facilities are available, adolescents may fall below the legal age of independent consent for these services [61]. Mortality and morbidity among HIV-infected youth in sub-Saharan Africa In contrast to the significant decline in global deaths from AIDS-related causes over the past decade [1,18,49], deaths among adolescents have increased during this period [62,63]. HIV currently ranks second among global causes of adolescent deaths [64], and one study found a nearly 50 increase in adolescent AIDS-related deaths between 2005 and 2012 [12]. This increase has occurred predominantly in the African region. Neurocognitive deficits and psychiatric symptoms are complications among individuals of all jir.2014.0227 ages with HIV and have implications for adherence. Several studies conducted in well-resourced settings have reported a high prevalence of neurocognitive and psychiatric morbidity among HIV-infected adolescents compared to those uninfected [65?7]. In addition, emotional and behavioural problems are more frequently observed among HIV-infected adolescents, compared to normative data or comparison groups [68]. Rates, however, vary across studies, with some researchers reporting no difference between infected and uninfected groups, or even more psychological problems among uninfected adolescents than those infected [68]. Most research into neuropsychological outcomes of HIV/AIDS in sub-Saharan Africa has focused on adult [69?4] or paediatric [75?8] populations, and there is a need for adolescent studies in this area. Adherence to ART Adherence to ART in HIV-infected individuals is a strong determinant of disease outcome. Interventions which improve adherence are associated with successful viral suppression, reduced risk of opportunistic infections and prevention of drug resistance [79?1]. Although ad.