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Sudjaritruk T, Kanjanavanit S, Chaito T, Sricharoen N, Prasarakee C, Sarachai S, Puthanakit T. A Three-Year Follow-Up of Bone Density Among Thai Adolescents With Perinatally Acquired HIV After Completion of Vitamin D and Calcium Supplementation. J Adolesc Health 2023; 73:262-270. [PMID: 37294251 PMCID: PMC10523922 DOI: 10.1016/j.jadohealth.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/14/2023] [Accepted: 03/29/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE To determine changes in bone mineral density (BMD) and bone metabolism-related biomarkers among Thai adolescents with perinatally acquired HIV infection (PHIVA) at 3 years following completion of vitamin D and calcium (VitD/Cal) supplementation. METHODS An observational follow-up study was conducted among PHIVA who received 48-week VitD/Cal supplementation (either high-dose [3,200 IU/1,200 mg daily] or standard-dose [400 IU/1,200 mg daily]). Lumbar spine BMD (LSBMD) was assessed by dual-energy x-ray absorptiometry. Serum 25-hydroxyvitamin D, intact parathyroid hormone, and bone turnover markers were measured. Changes in LSBMD z-scores and other bone parameters at 3 years after stopping VitD/Cal supplementation compared with baseline or week 48 of supplementation were assessed among participants previously receiving high-dose and standard-dose VitD/Cal supplementation. RESULTS Of 114 enrolled PHIVA, 46% and 54% had previously received high-dose and standard-dose VitD/Cal supplementation, respectively. The median age was 20 years; 53% were male. At 3 years after completion of VitD/Cal supplementation, we observed a significant decline in 25-hydroxyvitamin D and increase in intact parathyroid hormone but no significant rebounds of C-terminal telopeptides of collagen type I and procollagen type I amino-terminal propeptides and no significant changes in LSBMD z-scores among PHIVA in both treatment groups, compared with the measurements at week 48 of supplementation. Notably, LSBMD z-scores at 3 years after stopping VitD/Cal supplements were not significantly altered from baseline evaluations in both PHIVA groups. DISCUSSION Three years after completion of high-dose or standard-dose VitD/Cal supplementation, LSBMD z-scores of our Thai PHIVA were not significantly changed from baseline and week 48 of supplementation. VitD/Cal supplementation of PHIVA during periods of peak bone mass accrual may have sustained and long-term skeletal benefits.
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Affiliation(s)
- Tavitiya Sudjaritruk
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
| | | | - Tanachot Chaito
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Natthanidnan Sricharoen
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chanidapa Prasarakee
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Saowalak Sarachai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Thanyawee Puthanakit
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Centre of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Chantaratin S, Trimetha K, Werarak P, Lapphra K, Maleesatharn A, Rungmaitree S, Wittawatmongkol O, Phongsamart W, Kongstan N, Khumcha B, Chokephaibulkit K. Depression and Anxiety in Youth and Young Adults Living with HIV: Frequency and Associated Factors in Thai Setting. J Int Assoc Provid AIDS Care 2022; 21:23259582221101811. [PMID: 35581716 PMCID: PMC9121500 DOI: 10.1177/23259582221101811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Integrative mental health care in HIV patients is an important contributor to
successful therapy. This is a cross-sectional study in youth and young adults
who attend routine HIV clinic at a tertiary care centre in Bangkok. We recruited
100 youth and 130 young adults living with HIV to evaluate the frequency of
depression and anxiety and associated sociodemographic including sexual
orientation and health-related behaviours. Overall, about a fifth of the
participants had significant depression or anxiety. Interestingly, we found
different factors associated with depression in youth and young adults living
with HIV. Loss of their father, loss of close relatives or friends, and being
unemployed or school exclusion were the factors associate with depression in
youth; while dangerous alcohol use, feeling discriminated against and having
lipodystrophy were factors in young adults. The understanding of the frequency
and different associated factors can inform more effective prevention and
treatment strategies.
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Affiliation(s)
- Sasitorn Chantaratin
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand
| | - Kawita Trimetha
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand
| | - Peerawong Werarak
- Department of Preventive Medicine, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand
| | - Keswadee Lapphra
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand
| | - Alan Maleesatharn
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand.,Department of Preventive Medicine, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand
| | - Supattra Rungmaitree
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand
| | - Orasri Wittawatmongkol
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand
| | - Wanatpreeya Phongsamart
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand
| | - Nantaka Kongstan
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand
| | - Benjawan Khumcha
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand
| | - Kulkanya Chokephaibulkit
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand.,Siriraj Institute of Clinical Research, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand
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Sudjaritruk T, Bunupuradah T, Aurpibul L, Kanjanavanit S, Chotecharoentanan T, Sricharoen N, Ounchanum P, Suntarattiwong P, Pornpaisalsakul K, Puthanakit T. Impact of vitamin D and calcium supplementation on bone mineral density and bone metabolism among Thai adolescents with perinatally acquired HIV infection: A randomized clinical trial. Clin Infect Dis 2021; 73:1555-1564. [PMID: 34125899 DOI: 10.1093/cid/ciab547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To evaluate the impact of vitamin D and calcium supplementation(VitD/Ca) on lumbar spine bone mineral density(LSBMD) and bone metabolism among Thai adolescents with perinatally acquired HIV(PHIVA). METHODS A multicenter, randomized, active-control, open-labeled trial was conducted. PHIVA(aged10-20years) who were on stable cART were enrolled. Baseline LSBMD status was defined as low(z-score≤-2) and normal(z-score>-2). Eligible PHIVA were randomly assigned to receive standard-dose VitD/Ca (400IU/1,200mg daily), or high-dose VitD/Ca supplementation (400IU/1,200mg daily plus ergocalciferol 20,000IU weekly) for 48 weeks (ratio 1:1,stratified by baseline LSBMD). Study outcomes were the changes in LSBMD, LSBMD z-scores, and bone metabolism-related biomarkers (25-hydoxyvitamin D[25OHD], intact parathyroid hormone[iPTH], C-terminal telopeptide[CTX], procollagen type I amino-terminal propeptide[PINP]) from baseline to week48. RESULTS Among 200 enrolled PHIVA, a median age was 16 (IQR:14-18)years; 61% were on NNRTI-based cART. The median 25OHD level was 25.5 (IQR:20.8-33.0)ng/ml. After a 48-week VitD/Ca supplementation, LSBMD significantly increased in both treatment groups (high-dose,median:+0.07g/cm 2,IQR:+0.04 to +0.11g/cm 2,P<0.001; standard-dose,median:+0.09g/cm 2, IQR:+0.03 to +0.13g/cm 2,P<0.001). Notably, the change in LSBMD z-scores was significantly greater in high-dose versus standard-dose groups (median:+0.4,IQR:-0.1 to +0.9 versus median:+0.1,IQR:-0.4 to +0.7;P=0.02). The levels of 25OHD increased, whereas iPTH, CTX, and PINP declined significantly in both groups(P<0.05); but no between-group differences were demonstrated. CONCLUSIONS Over the 48-week VitD/Ca supplementation, significant increase in LSBMD, and significant decreases in bone metabolism-related markers were observed among our Thai PHIVA in both treatment groups. The improvement in LSBMD z-score was more enhanced with high-dose VitD/Ca supplementation compared with standard-dose. High-dose VitD/Ca supplementation might be considered to promote bone health in this population.
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Affiliation(s)
- Tavitiya Sudjaritruk
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Torsak Bunupuradah
- The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Center, Bangkok, Thailand
| | - Linda Aurpibul
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | | | - Natthanidnan Sricharoen
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | | | - Krittaporn Pornpaisalsakul
- Centre of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thanyawee Puthanakit
- Centre of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Brick LAD, Nugent NR, Kahana SY, Bruce D, Tanney MR, Fernández MI, Bauermeister JA. Interaction Effects of Neighborhood Disadvantage and Individual Social Support on Frequency of Alcohol Use in Youth Living with HIV. Am J Community Psychol 2018; 61:276-284. [PMID: 29400400 DOI: 10.1002/ajcp.12227] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Youth living with HIV (YLH) experience multiple disease-related stresses along with the same structural and developmental challenges faced by their uninfected peers; alcohol use among YLH represents a risk behavior by virtue of potential effects on youth health and increased likelihood of engaging in unprotected sex while drinking alcohol. Research aimed at better understanding the interplay of individual- and neighborhood-level influences on alcohol use for YLH is needed to inform interventions. This study examined whether socioeconomic disadvantage (SED) and social support influence, independently and through interaction, alcohol use in YLH. Data from the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) consisted of YLH across 538 neighborhoods in the United States who acquired HIV behaviorally. Neighborhood-specific data were compiled from the 2010 U.S. Census Bureau and matched with individual-level data from the ATN (N = 1,357) to examine effects that contribute to variation in frequency of alcohol use. Other drug use, being male, being non-Black, and older age were associated with greater alcohol use. Higher social support was negatively associated with alcohol use frequency. A cross-level interaction indicated that the association found between decreasing social support and increasing alcohol use frequency was weakened in areas with lower SED. Implications are discussed.
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Affiliation(s)
- Leslie Ann D Brick
- Division of Behavioral Genetics, Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
| | - Nicole R Nugent
- Division of Behavioral Genetics, Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Douglas Bruce
- Department of Health Sciences, DePaul University, Chicago, IL, USA
| | - Mary R Tanney
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - M Isabel Fernández
- College of Osteopathic Medicine, Nova Southeastern University, Davis, FL, USA
| | - Jose A Bauermeister
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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Manaboriboon B, Lolekha R, Chokephaibulkit K, Leowsrisook P, Naiwatanakul T, Tarugsa J, Durier Y, Aunjit N, Punpanich Vandepitte W, Boon-Yasidhi V. Psychosocial needs of perinatally HIV-infected youths in Thailand: lessons learnt from instructive counseling. AIDS Care 2016; 28:1615-1622. [PMID: 27346127 DOI: 10.1080/09540121.2016.1198745] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Identifying psychosocial needs of perinatally HIV-infected (pHIV) youth is a key step in ensuring good mental health care. We report psychosocial needs of pHIV youth identified using the "Youth Counseling Needs Survey" (YCS) and during individual counseling (IC) sessions. pHIV youth receiving care at two tertiary-care hospitals in Bangkok or at an orphanage in Lopburi province were invited to participate IC sessions. The youths' psychosocial needs were assessed using instructive IC sessions in four main areas: general health, reproductive health, mood, and psychosocial concerns. Prior to the IC session youth were asked to complete the YCS in which their concerns in the four areas were investigated. Issues identified from the YCS and the IC sessions were compared. During October 2010-July 2011, 150 (68.2%) of 220 eligible youths participated in the IC sessions and completed the YCS. Median age was 14 (range 11-18) years and 92 (61.3%) were female. Mean duration of the IC sessions was 36.5 minutes. One-hundred and thirty (86.7%) youths reported having at least one psychosocial problem discovered by either the IC session or the YCS. The most common problems identified during the IC session were poor health attitude and self-care (48.0%), lack of life skills (44.0%), lack of communication skills (40.0%), poor antiretroviral (ARV) adherence (38.7%), and low self-value (34.7%). The most common problems identified by the YCS were lack of communication skills (21.3%), poor health attitude and self-care (14.0%), and poor ARV adherence (12.7%). Youth were less likely to report psychosocial problems in the YCS than in the IC session. Common psychosocial needs among HIV-infected youth were issues about life skills, communication skills, knowledge on self-care, ARV adherence, and self-value. YCS can identify pHIV youths' psychosocial needs but might underestimate issues. Regular IC sessions are useful to detect problems and provide opportunities for counseling.
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Affiliation(s)
- B Manaboriboon
- a Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University , Bangkok , Thailand
| | - R Lolekha
- b Global AIDS Program (GAP) Thailand Asia Regional Office , Thailand MOPH - U.S. CDC Collaboration (TUC) , Bangkok , Thailand
| | - K Chokephaibulkit
- a Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University , Bangkok , Thailand
| | - P Leowsrisook
- c Division of Infectious Diseases, Ministry of Public Health , Queen Sirikit National Institute of Child Health (QSNICH) , Bangkok , Thailand
| | - T Naiwatanakul
- b Global AIDS Program (GAP) Thailand Asia Regional Office , Thailand MOPH - U.S. CDC Collaboration (TUC) , Bangkok , Thailand
| | - J Tarugsa
- a Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University , Bangkok , Thailand
| | - Y Durier
- a Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University , Bangkok , Thailand
| | - N Aunjit
- c Division of Infectious Diseases, Ministry of Public Health , Queen Sirikit National Institute of Child Health (QSNICH) , Bangkok , Thailand
| | - W Punpanich Vandepitte
- c Division of Infectious Diseases, Ministry of Public Health , Queen Sirikit National Institute of Child Health (QSNICH) , Bangkok , Thailand
| | - V Boon-Yasidhi
- a Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University , Bangkok , Thailand
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Lolekha R, Boon-Yasidhi V, Leowsrisook P, Naiwatanakul T, Durier Y, Nuchanard W, Tarugsa J, Punpanich W, Pattanasin S, Chokephaibulkit K. Knowledge, attitudes, and practices regarding antiretroviral management, reproductive health, sexually transmitted infections, and sexual risk behavior among perinatally HIV-infected youth in Thailand. AIDS Care 2014; 27:618-28. [PMID: 25506754 DOI: 10.1080/09540121.2014.986046] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
More than 30% of perinatally HIV-infected children in Thailand are 12 years and older. As these youth become sexually active, there is a risk that they will transmit HIV to their partners. Data on the knowledge, attitudes, and practices (KAP) of HIV-infected youth in Thailand are limited. Therefore, we assessed the KAP of perinatally HIV-infected youth and youth reporting sexual risk behaviors receiving care at two tertiary care hospitals in Bangkok, Thailand and living in an orphanage in Lopburi, Thailand. From October 2010 to July 2011, 197 HIV-infected youth completed an audio computer-assisted self-interview to assess their KAP regarding antiretroviral (ARV) management, reproductive health, sexual risk behaviors, and sexually transmitted infections (STIs). A majority of youth in this study correctly answered questions about HIV transmission and prevention and the importance of taking ARVs regularly. More than half of the youth in this study demonstrated a lack of family planning, reproductive health, and STI knowledge. Girls had more appropriate attitudes toward safe sex and risk behaviors than boys. Although only 5% of the youth reported that they had engaged in sexual intercourse, about a third reported sexual risk behaviors (e.g., having or kissing boy/girlfriend or consuming an alcoholic beverage). We found low condom use and other family planning practices, increasing the risk of HIV and/or STI transmission to sexual partners. Additional resources are needed to improve reproductive health knowledge and reduce risk behavior among HIV-infected youth in Thailand.
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Affiliation(s)
- Rangsima Lolekha
- a Global AIDS Program Thailand Asia Regional Office , Thailand Ministry of Public Health (MOPH) - U.S. Centers for Disease Control and Prevention (CDC) Collaboration , Nonthaburi , Thailand
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