Mental health and risk behaviors of adolescents and young adults with perinatal HIV: a systematic review of literature.
André Assis, Mariana Gonçalves, Tânia Gonçalves et al.
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In 30 seconds
This systematic review examined mental health, risk behaviors, and quality of life among adolescents and young adults with perinatally acquired HIV (PHIV+), including comparisons with perinatally exposed but uninfected and HIV-negative peers. It included 26 studies published from 2006 to 2025. Anxiety prevalence ranged from 4-49% and mood disorders from 3-36%; most studies found no significant differences by HIV status. Substance use, unprotected sex, and self-harm were also reported, without consistent associations with HIV status. The review suggests contextual and environmental factors may be more influential than HIV status alone.
Key findings
- Across studies, anxiety prevalence among PHIV+ participants ranged from 4-49%, and mood disorder prevalence ranged from 3-36%.
- Most studies found no significant mental health differences between PHIV+ participants and HIV-negative or PHEU peers.
- Reported risk behaviors included substance use (4-34%), unprotected sex (19-62%), and self-harm (10-27%); associations with HIV status were inconsistent.
- Quality of life was generally poorer among PHIV+ participants, with several studies linking it to caregiver illness and socioeconomic adversity.
Why it matters
The findings caution against attributing mental health or behavioral difficulties in young people with perinatal HIV to HIV status alone. Caregiver health and socioeconomic adversity may also be relevant to wellbeing, while evidence concerning stigma and trauma remains limited and inconsistent. Recognizing this broader context can help frame assessment and support without assuming that HIV status explains observed outcomes.
What to keep in mind
Substantial heterogeneity in study designs, outcome measures, and comparison groups limited direct comparisons across studies.