Exposure to Violence and Virologic and Immunological Outcomes Among Youth With Perinatal HIV in the Pediatric HIV/AIDS Cohort Study.

Deborah Kacanek
Kathleen Malee
Claude A Mellins
Katherine Tassiopoulos
Renee Smith
Mitzie L Grant, Dept. of Psychiatry, Drexel University College of Medicine, Philadelphia, PA
Sonia Lee
Danish Q Siddiqui
Ana Puga


PURPOSE: Exposure to violence in childhood has been linked to adverse health outcomes. Little is known about the prevalence and relationship of youth and caregiver violence exposure to clinical outcomes among youth with perinatal human immunodeficiency virus (HIV) infection (PHIV). We evaluated associations of youth and caregiver violence exposure with unsuppressed viral load (VL) (HIV RNA > 400 copies/mL) and CD4%

METHODS: Annual clinical examination, record abstraction, and interview data were collected, including youth report of recent exposure to violence and caregivers' self-report of being assaulted/abused in adulthood. Multivariable logistic regression methods were used to calculate adjusted odds ratios for unsuppressed VL and CD4%

RESULTS: Among 268 youth with PHIV (53% girls, mean age 12.8 years, 21% white, 42% with household income <$20,000/year), 34% reported past year violence exposure; 30% had a caregiver who reported being assaulted in adulthood. One quarter of youth (24%) had unsuppressed VL and 22% had CD4%

CONCLUSIONS: Youth with PHIV report a high prevalence of recent violence exposure, which was associated with poor virologic and immunologic outcomes. Reducing violence and providing support to youth with violence exposure and PHIV may improve health outcomes.