Psychosocial dysfunction and delayed sexual development among adolescents living with HIV in Lagos, Nigeria.
Main Article Content
Keywords
Psychosocial Dysfunction, Delayed Sexual Development, Human Immunodeficiency Virus, HIV, Tanner Staging
Abstract
Background: With increasing survival following the use of antiretroviral therapy, adolescents living with Human Immunodeficiency Virus (ALHIV) could have complications such as delayed puberty and psychological complications. In Nigeria, there is limited data on the association between delayed sexual maturation and psychosocial dysfunction in ALHIV. The objective of this study was to determine the prevalence and the association between delayed sexual development (DSD) and psychosocial dysfunction (PSD) in ALHIV and compare it with uninfected adolescents.
Methodology: This was a cross-sectional study carried out at the Lagos University Teaching Hospital (LUTH), Nigeria and it involved 144 ALHIV and an equal number of HIV-negative controls who were matched for age, sex and social class. Information was obtained from participants using interviewer-administered questionnaires; their stages of sexual development and their psychosocial function were assessed using Tanner staging criteria and the Paediatric Symptom Checklist tool respectively. Data were analysed using the Statistical Package for Social Sciences software version 23.
Results: The mean (±SD) age of ALHIV and the HIV-negative controls was 14.8 (±3.0) and 14.8 (±2.9) years respectively. All the ALHIV were on HAART and 99.3% were in clinical stage 1. There was no significant difference between the prevalence of DSD among the ALHIV (9.4%) and the HIV-negative controls (6.4%) (p= 0.402). The prevalence of PSD in ALHIV and HIV-negative controls were 4.9% and 5.6% respectively (p=0.791). There was no significant association between PSD and DSD in both groups of study participants (p=0.459 and p=0.301).
Conclusion: The prevalence of PSD and DSD were low and similar among adolescents with and without HIV, and no association was found between PSD and DSD. However, routine screening of adolescents for PSD should be practised for early identification and prompt management where indicated.
References
2. UNAIDS. Joint United Nations Programme on HIV and AIDS 2014. The Gap report: Children and Pregnant Women Living with HIV. 2014. Available from: https://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdf.
[Accessed 9th April 2021].
3. UNAIDS. Nigeria 2021. HIV and AIDS Estimates. Available from: https://www.unaids.org/en/regionscountries/countries/nigeria [Accessed 13th May 2023].
4. Kemigisha E, Zanoni B, Bruce K, Menjivar R, Kadengye D, Atwine D, et al. Prevalence of depressive symptoms and associated factors among adolescents living with HIV/AIDS in South Western Uganda. AIDS care. 2019;31(10):1297-303.
5. Betancourt TS, Rubin-Smith JE, Beardslee WR, Stulac SN, Fayida I, Safren S. Understanding locally, culturally, and contextually relevant mental health problems among Rwandan children and adolescents affected by HIV/AIDS. AIDS care. 2011;23(4):401-12.
6. Vreeman RC, Scanlon ML, McHenry MS, Nyandiko WM. The physical and psychological effects of HIV infection and its treatment on perinatally HIV‐infected children J. Int. AIDS Soc. 2015;18:20258.
7. Williams PL, Abzug MJ, Jacobson DL, Wang J, Van Dyke RB, Hazra R, et al. Pubertal onset in HIV-infected children in the era of combination Antiretroviral Treatment. AIDS (London, England). 2013;27:12: 1959.
8. Szubert AJ, Musiime V, Bwakura-Dangarembizi M, Nahirya-Ntege P, Kekitiinwa A, Gibb DM, et al. Pubertal development in HIV-infected African children on first-line antiretroviral therapy. AIDS (London, England). 2015;29:5: 609.
9. Iloh ON, Iloh KK, Ubesie AC, Emodi IJ, Ikefuna AN, Ibeziako NS. Comparison of Tanner staging of HIV-infected and uninfected girls at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria. J. Paediatr. Endocrinol. Metab. 2017;30(7):725-9.
10. David AN, Gbajabiamila T, Salako A, Odubela O, Wapmuk A,Ekama S, et al. Growth and Pubertal Development Among HIV Infected and Uninfected Adolescent Girls in Lagos, Nigeria: A Comparative Cross-Sectional Study. Glob. Paediatr. Health. 2022;9:2333794X221082784.
11. Ndiokwelu CO, Uwaezuoke SN, Iloh KK. Physical growth and sexual maturation of perinatally HIV-infected adolescent males in a southeast Nigerian tertiary hospital: a comparative cross-sectional study. BMC pediatr. 2022;22:1: 573.
12. Bankole KO, Bakare MO, Edet BE, Igwe MN, Ewa AU, Bankole IA, et al. Psychological complications associated with HIV/AIDS infection among children in South-South Nigeria, sub-Saharan Africa. Cogent Med. 2017 2017/01/01;4(1):1372869.
13. Lawan UM, Amole G, Jahun M, Abute J. Psychosocial challenges and adherence to antiretroviral therapy among HIV-positive adolescents attending an ART centre in Kano, northwestern Nigeria. Int J Med Sci Public Health. 2015;4(10):1439-44.
14. SM A. Growth failure in children with HIV infection. J Acquir Immune Defic Syndr. 2000;1:S37-42.
15. Onwasigwe C. Principles and methods of epidemiology. EL ‘DEMAK publishers Uwani Enugu. 2010:p173.
16. Kaplowitz PB. Delayed Puberty. In: Kappy MS, Allen DB, Geffner ME. (eds.) Pediatric practice Endocrinology. McGraw Hill Companies; 2010. p. 277.
17. Jellinek MS, Murphy JM, Robinson J, Feins A, Lamb S, Fenton T. Paediatric Symptom Checklist: screening school-age children for psychosocial dysfunction. J. Paediatr. 1988;112(2):201-9.
18. Louthrenoo O, Oberdorfer P, Sirisanthana V. Psychosocial functioning in adolescents with perinatal HIV infection receiving highly active antiretroviral therapy. J Int Assoc Provid AIDS Care. 2014;13(2):178-83.
19. Brechtl JR, Breitbart W, Galietta M, Krivo S, Rosenfeld B. The use of highly active antiretroviral therapy (HAART) in patients with advanced HIV infection: impact on medical, palliative care, and quality of life outcomes. J Pain Symptom Manag. 2001;21(1): 41-51.
20. Lee HJ, Han SH, Boerner K. Psychological and physical health in widowhood: does marital quality make a difference? Res Aging. 2022;44(1): 54-64.
21. Bomba M, Nacinovich R, Oggiano S, Cassani M, Baushi L, Bertulli C, et al. Poor health-related quality of life and abnormal psychosocial adjustment in Italian children with perinatal HIV infection receiving highly active antiretroviral treatment. AIDS care. 2010;22(7):858-65.
22. Pannilage U. Impact of family on children’s wellbeing. J Sociol. Soc Work. 2017;5(1):149-58.
23. Bista B, Thapa P, Sapkota D, Singh SB, Pokharel PK. Psychosocial Problems among adolescent students: an exploratory study in the central region of Nepal. Front. Public Health. 2016;4:158.
24. McHugh G, Rylance J, Mujuru H, Nathoo K, Chonzi P, Dauya E, et al. Chronic morbidity among older children and adolescents at diagnosis of HIV infection. J. Acquir. Immune Defic. Syndr. (1999). 2016;73(3):275.
25. Oyewole OA, Oduwole A, Adediran AS. Age of Pubertal Maturation of Girls in South Western Nigeria. Niger J Med . 2022;31(4): 443-6.
26. Dwyer AA. Psychosexual effects resulting from delayed, incomplete, or absent puberty. Curr Opin Endocr Metab Res. 2020;14:15-21.
27. Zhu J, Chan Y-M. Adult consequences of self-limited delayed puberty. Paediatrics. 2017;139(6).
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