Abstract Body

Background:

Traumatic event exposure (TEE) is elevated amongst people living with HIV when compared to the general population and precedes negative outcomes such as mental illness, poor medication adherence, and viremia. Few studies have examined the impact of TEE on any of these outcomes in adolescents and young adults perinatally infected with HIV (PHIV) or perinatally exposed, but uninfected (PHEU). This largely urban and ethnically minoritized population bare a high burden of life stressors and mental illness and may be more vulnerable to TEE effects. This longitudinal analysis examines TEE prevalence experienced in childhood/adolescence among youth with PHIV (YPHIV) and PHEU (YPHEU) and assesses associations of cumulative TEE exposure with psychiatric or substance use disorders in young adulthood.

Methods:

YPHIV and YPHEU, ages 9-16 years, were recruited in New York City and interviewed every 12-18 months over 5 follow-ups (FUs). Data come from the DISC-IV, a psychiatric interview. Lifetime TEE data come from youth report at enrollment (mean age=12), FU1 (mean=14), and FU2 (mean=17). Past year psychiatric and substance use disorder data come from FU5, when participants were young adults (mean age=23). Logistic regressions tested associations between cumulative counts of childhood/adolescent TEE and young adult psychiatric and substance use diagnoses.

Results:

Among participants (N&#3f237, 54% female, 59% African American, 51% Latinx), 39% endorsed ≥4 lifetime TEE; and 21% endorsed 0 or 1 during youth study visits. At FU5, 26% had a past-year psychiatric diagnosis, and 28% had a substance use disorder. Experiencing 4 or more lifetime TEEs vs. 0 or 1 TEE was positively associated with both past-year psychiatric and past-year substance use diagnoses in young adulthood. Those who had been in a situation where they thought someone would be seriously hurt or killed had higher odds of both outcomes; those who had been upset by seeing a dead body had higher odds of a substance use disorder. There were no HIV-status group differences.

Conclusions:

YPHIV and YPHEU may be at high risk for TEE. TEE experienced in childhood/adolescence is associated with higher odds of psychiatric and substance use disorders in adulthood, which may lead to worse health outcomes in populations at risk for or living with HIV. Future work could investigate causal pathways between TEE and mental health and inform interventions to address long-term effects of TEE on health and mental health in youth affected by HIV.