Social, economic, and health effects of the COVID-19 pandemic on adolescents retained in or recently disengaged from HIV care in Kenya.

<h4>Introduction</h4>Adolescents living with HIV (ALHIV, ages 10-19) experience complex challenges to adhere to antiretroviral therapy (ART) and remain in care, and may be vulnerable to wide-scale disruptions during the COVID-19 pandemic. We assessed for a range of effects of the pandemi...

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Autores principales:	Leslie A Enane, Edith Apondi, Josephine Aluoch, Giorgos Bakoyannis, Jayne Lewis Kulzer, Zachary Kwena, Rami Kantor, Ashley Chory, Adrian Gardner, Michael Scanlon, Suzanne Goodrich, Kara Wools-Kaloustian, Batya Elul, Rachel C Vreeman
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ffbab6233900459a8fa7b4235532ebec
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spelling	oai:doaj.org-article:ffbab6233900459a8fa7b4235532ebec2021-12-02T20:06:20ZSocial, economic, and health effects of the COVID-19 pandemic on adolescents retained in or recently disengaged from HIV care in Kenya.1932-620310.1371/journal.pone.0257210https://doaj.org/article/ffbab6233900459a8fa7b4235532ebec2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257210https://doaj.org/toc/1932-6203<h4>Introduction</h4>Adolescents living with HIV (ALHIV, ages 10-19) experience complex challenges to adhere to antiretroviral therapy (ART) and remain in care, and may be vulnerable to wide-scale disruptions during the COVID-19 pandemic. We assessed for a range of effects of the pandemic on ALHIV in western Kenya, and whether effects were greater for ALHIV with recent histories of being lost to program (LTP).<h4>Methods</h4>ALHIV were recruited from an ongoing prospective study at 3 sites in western Kenya. The parent study enrolled participants from February 2019-September 2020, into groups of ALHIV either 1) retained in care or 2) LTP and traced in the community. Phone interviews from July 2020-January 2021 assessed effects of the pandemic on financial and food security, healthcare access and behaviors, and mental health. Responses were compared among the parent study groups.<h4>Results</h4>Phone surveys were completed with 334 ALHIV or their caregivers, including 275/308 (89.3%) in the retained group and 59/70 (84.3%) among those LTP at initial enrollment. During the pandemic, a greater proportion of LTP adolescents were no longer engaged in school (45.8% vs. 36.4%, p = 0.017). Over a third (120, 35.9%) of adolescents reported lost income for someone they relied on. In total, 135 (40.4%) did not have enough food either some (121, 36.2%) or most (14, 4.2%) of the time. More LTP adolescents (4/59, 6.8% vs. 2/275, 0.7%, p = 0.010) reported increased difficulties refilling ART. Adolescent PHQ-2 and GAD-2 scores were ≥3 for 5.6% and 5.2%, respectively.<h4>Conclusions</h4>The COVID-19 pandemic has had devastating socioeconomic effects for Kenyan ALHIV and their households. ALHIV with recent care disengagement may be especially vulnerable. Meanwhile, sustained ART access and adherence potentially signal resilience and strengths of ALHIV and their care programs. Findings from this survey indicate the critical need for support to ALHIV during this crisis.Leslie A EnaneEdith ApondiJosephine AluochGiorgos BakoyannisJayne Lewis KulzerZachary KwenaRami KantorAshley ChoryAdrian GardnerMichael ScanlonSuzanne GoodrichKara Wools-KaloustianBatya ElulRachel C VreemanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0257210 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Leslie A Enane Edith Apondi Josephine Aluoch Giorgos Bakoyannis Jayne Lewis Kulzer Zachary Kwena Rami Kantor Ashley Chory Adrian Gardner Michael Scanlon Suzanne Goodrich Kara Wools-Kaloustian Batya Elul Rachel C Vreeman Social, economic, and health effects of the COVID-19 pandemic on adolescents retained in or recently disengaged from HIV care in Kenya.
description	<h4>Introduction</h4>Adolescents living with HIV (ALHIV, ages 10-19) experience complex challenges to adhere to antiretroviral therapy (ART) and remain in care, and may be vulnerable to wide-scale disruptions during the COVID-19 pandemic. We assessed for a range of effects of the pandemic on ALHIV in western Kenya, and whether effects were greater for ALHIV with recent histories of being lost to program (LTP).<h4>Methods</h4>ALHIV were recruited from an ongoing prospective study at 3 sites in western Kenya. The parent study enrolled participants from February 2019-September 2020, into groups of ALHIV either 1) retained in care or 2) LTP and traced in the community. Phone interviews from July 2020-January 2021 assessed effects of the pandemic on financial and food security, healthcare access and behaviors, and mental health. Responses were compared among the parent study groups.<h4>Results</h4>Phone surveys were completed with 334 ALHIV or their caregivers, including 275/308 (89.3%) in the retained group and 59/70 (84.3%) among those LTP at initial enrollment. During the pandemic, a greater proportion of LTP adolescents were no longer engaged in school (45.8% vs. 36.4%, p = 0.017). Over a third (120, 35.9%) of adolescents reported lost income for someone they relied on. In total, 135 (40.4%) did not have enough food either some (121, 36.2%) or most (14, 4.2%) of the time. More LTP adolescents (4/59, 6.8% vs. 2/275, 0.7%, p = 0.010) reported increased difficulties refilling ART. Adolescent PHQ-2 and GAD-2 scores were ≥3 for 5.6% and 5.2%, respectively.<h4>Conclusions</h4>The COVID-19 pandemic has had devastating socioeconomic effects for Kenyan ALHIV and their households. ALHIV with recent care disengagement may be especially vulnerable. Meanwhile, sustained ART access and adherence potentially signal resilience and strengths of ALHIV and their care programs. Findings from this survey indicate the critical need for support to ALHIV during this crisis.
format	article
author	Leslie A Enane Edith Apondi Josephine Aluoch Giorgos Bakoyannis Jayne Lewis Kulzer Zachary Kwena Rami Kantor Ashley Chory Adrian Gardner Michael Scanlon Suzanne Goodrich Kara Wools-Kaloustian Batya Elul Rachel C Vreeman
author_facet	Leslie A Enane Edith Apondi Josephine Aluoch Giorgos Bakoyannis Jayne Lewis Kulzer Zachary Kwena Rami Kantor Ashley Chory Adrian Gardner Michael Scanlon Suzanne Goodrich Kara Wools-Kaloustian Batya Elul Rachel C Vreeman
author_sort	Leslie A Enane
title	Social, economic, and health effects of the COVID-19 pandemic on adolescents retained in or recently disengaged from HIV care in Kenya.
title_short	Social, economic, and health effects of the COVID-19 pandemic on adolescents retained in or recently disengaged from HIV care in Kenya.
title_full	Social, economic, and health effects of the COVID-19 pandemic on adolescents retained in or recently disengaged from HIV care in Kenya.
title_fullStr	Social, economic, and health effects of the COVID-19 pandemic on adolescents retained in or recently disengaged from HIV care in Kenya.
title_full_unstemmed	Social, economic, and health effects of the COVID-19 pandemic on adolescents retained in or recently disengaged from HIV care in Kenya.
title_sort	social, economic, and health effects of the covid-19 pandemic on adolescents retained in or recently disengaged from hiv care in kenya.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/ffbab6233900459a8fa7b4235532ebec
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Social, economic, and health effects of the COVID-19 pandemic on adolescents retained in or recently disengaged from HIV care in Kenya.

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