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AN ADOLESCENT LIVING WITH HIV - A SUCCESS STORY FROM TREATMENT FAILURE

Authors:

Abstract

The most significant issues of managing adolescents with retroviral disease is an impact of the disease towards the adolescents, their quality of life and future marriage, stigma by the public and the patient’s perception to the treatment and disease. We report a case of an 18-year-old girl, underlying HIV infection transmitted from her parents, neglected from receiving adequate rights for her treatment since diagnosis.
15th NATIONAL SYMPOSIUM ON ADOLESCENT
HOSPITAL SULTANAH BAHIYAH,
ALOR SETAR, KEDAH
4-6 APRIL 2019
AN ADOLESCENT LIVING WITH HIV –
A SUCCESS STORY FROM TREATMENT FAILURE
Mohd Shaiful Ehsan Shalihin1, Iskandar Firzada Osman2, Nurul Akmanidar Zainuddin1
1International Islamic University of Malaysia, 2Klinik Kesihatan Jaya Gading
Retroviral disease in adolescents is increasing in
trend worldwide in view of early sexual exposure
with multiple partners among adolescents. 1-3
However, if the infection is originated from
vertical transmission, it definitely comes with
discriminatory social stigma that will take away
the childs happiness and quality of life.1-3
Moreover, it precipitates depressive and anxiety
disorder since early childhood.
We report a case of an 18-year-old girl,
underlying HIV infection transmitted from her
parents, neglected from receiving adequate
rights for her treatment since diagnosis.
An unemployed girl with underlying HIV came to
us with high probability of treatment failure due
to recurrent missed follow-up and medications in
previous treatment centre.
Her main obstacles are basically her poor social
support and broken family psychodynamics. Her
initial CD4 counts upon arrival to us is 16 cells
with viral load of 177,138.
Rather than referring her to infectious disease
centre for drug resistance assessment, we
subjected her under our strict follow-up at our
health clinic and arranged family meeting to gain
back the family support and the patients trust
towards herself and the treatment.
We involved multidisciplinary team including
social welfare, support group and occupational
therapist to boost back her motivation.
We restarted back the ART with another cART
combination of Emtricitabine-Tenofovir and
Efavirenz and her condition and parameters
improved tremendously together with her
compliance.
The most significant issues of managing
adolescents with retroviral disease is an impact
of the disease towards the adolescents, their
quality of life and future marriage, stigma by the
public and the patients perception to the
treatment and disease.1-3
One of the reasons for defaulted follow up of
adolescents is due to poor retention care at the
health clinic. Rather than focusing on the
patients factors alone, flaws at the management
at primary care level should be taken into
consideration.1-3
No wrong door policy, integrated health care
services and well trained non-judgemental staff
has enabled to boost adolescents trust towards
themselves, treatment plan and hope for future.2
By providing channel for them to further studies
and involvement back in the community, their
mental health will be preserved and indirectly
leads to a good control of the retroviral disease.2
This case highlights the role of primary care
providers as an advocate in exploring the psycho-
social factors that may contribute to
non-adherence of cART. There is still a role of
treating suspected treatment failure in primary care
clinic, especially those clinically stable patient who
require assistance for social support with patient-
centered approach, which is one of the main
principle in primary health care.
1) Ministry of Health, M.M., Naonal Adolescent Health - Plan of Acon
2015-2020 2015.
2) Ministry of Health, M., Garis Panduan Pelaksanaan Perkhidmatan
Kesihatan Remaja di Peringkat Kesihatan Primer, F.H.D. Division, Editor.
2013.
3) (MSHM), M.S.f.H.M., Naonal HIV Treatment Update 2016, in Naonal
HIV Treatment Update 2016. 2016.
CASE REPORT
DISCUSSION
CONCLUSION
REFERENCES
INTRODUCTION
ResearchGate has not been able to resolve any citations for this publication.
National Adolescent Health -Plan of Action
  • M M Ministry Of Health
Ministry of Health, M.M., National Adolescent Health -Plan of Action 2015-2020 2015.
Garis Panduan Pelaksanaan Perkhidmatan
  • M Ministry Of Health
Ministry of Health, M., Garis Panduan Pelaksanaan Perkhidmatan Kesihatan Remaja di Peringkat Kesihatan Primer, F.H.D. Division, Editor. 2013.