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<p>Adolescents and young adults with perinatally acquired HIV (APHIV) face intersecting challenges that compromise resilience, an important determinant of treatment engagement and health outcomes. Evidence on peer-led interventions to strengthen resilience among APHIV in South Asia remains limited. We evaluated resilience and its correlates among participants in the I’mPossible Fellowship, a peer-led mentorship program in India. We conducted a cross-sectional evaluation of 216 APHIV who completed the 24-month fellowship in southern India in 2024. Trained youth investigators administered surveys assessing sociodemographic, educational, and clinical characteristics. Resilience was measured using the Child and Youth Resilience Measure-Revised (CYRM-R). Low resilience was defined as CYRM-R score ≤ 33rd percentile. Multivariable logistic regression identified independent correlates of low resilience. Participants had a mean age of 18.7y (range 9–24). For 50%, both parents were deceased, and 43% lived in childcare institutions. Median resilience scores were high (74, IQR 69–78), and 91% were virally suppressed. Independent correlates of low resilience were loss of both parents (aOR 4.35, 95% CI 2.09–9.06), school discontinuation (aOR 2.43, 95% CI 1.10–5.34), and communication barriers at HIV clinics (aOR 5.83, 95% CI 2.69–12.64). These findings were consistent across sensitivity analyses using alternative CYRM-R thresholds. At the stringent resilience threshold of ≤ 15th percentile, unsuppressed viral load emerged an additional significant correlate of low resilience. We conclude that APHIV participating in this peer-led mentorship program demonstrated high resilience and viral suppression. Results highlighted modifiable structural and psychosocial vulnerabilities that could inform targeted interventions to improve outcomes among those facing the greatest adversity.</p>

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Resilience and Its Determinants Among Adolescents and Young Adults with Perinatally Acquired HIV Enrolled in a Peer-Led Mentorship Program in India

  • 期刊论文

  • 发表日期：

    2026年7月16日

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  • Anita Shet,
  • Michael Raj,
  • Siddha Sannigrahi,
  • Babu Seenappa,
  • Lakshmikanth Reddy,
  • Ashley Sharma,
  • Akshay G. Narayanan,
  • S. K. Satish Kumar,
  • Lakshmi Ganapathi

摘要

Adolescents and young adults with perinatally acquired HIV (APHIV) face intersecting challenges that compromise resilience, an important determinant of treatment engagement and health outcomes. Evidence on peer-led interventions to strengthen resilience among APHIV in South Asia remains limited. We evaluated resilience and its correlates among participants in the I’mPossible Fellowship, a peer-led mentorship program in India. We conducted a cross-sectional evaluation of 216 APHIV who completed the 24-month fellowship in southern India in 2024. Trained youth investigators administered surveys assessing sociodemographic, educational, and clinical characteristics. Resilience was measured using the Child and Youth Resilience Measure-Revised (CYRM-R). Low resilience was defined as CYRM-R score ≤ 33rd percentile. Multivariable logistic regression identified independent correlates of low resilience. Participants had a mean age of 18.7y (range 9–24). For 50%, both parents were deceased, and 43% lived in childcare institutions. Median resilience scores were high (74, IQR 69–78), and 91% were virally suppressed. Independent correlates of low resilience were loss of both parents (aOR 4.35, 95% CI 2.09–9.06), school discontinuation (aOR 2.43, 95% CI 1.10–5.34), and communication barriers at HIV clinics (aOR 5.83, 95% CI 2.69–12.64). These findings were consistent across sensitivity analyses using alternative CYRM-R thresholds. At the stringent resilience threshold of ≤ 15th percentile, unsuppressed viral load emerged an additional significant correlate of low resilience. We conclude that APHIV participating in this peer-led mentorship program demonstrated high resilience and viral suppression. Results highlighted modifiable structural and psychosocial vulnerabilities that could inform targeted interventions to improve outcomes among those facing the greatest adversity.