Socioeconomic, clinical, and behavioral characteristics of adolescents living with HIV in Southwest Nigeria: implication for preparedness for transition to adult care.

There is a need to generate data that demonstrate preparedness (or a lack of it) of adolescents to crossover to adult care to inform policy and create appropriate models in LMICs. This cross-sectional survey of 252 adolescents (15-19 years) receiving HIV-care assessed sociodemographic characteristics, clinical and ART status, and HIV-related behaviors. Also, the study appraised HIV status awareness, and disclosure, and access to healthcare. The mean age of the participants was 16.41 (SD = 1.41) years, and 128 (50.8%) of them were female. The mean adherence level (by VAS) reported was 73.05 ± 16.75. The most frequently reported reasons for missing medications were forgetting (39.6%), falling asleep (37.7%), being away from home (33.8%), and being too busy with other endeavors (32.6%). Most (93.7%) of the participants paid for health care services out-of-pocket. Many (38.1%) of them did not know how they acquired HIV infection. About half (44.8%) of them had boy/girlfriends, but only 25 (9.9%) reported ever having sex. Only 4% disclosed their HIV status to their boy/girlfriends. Critical gaps exist in adolescents' preparedness for transition to adult HIV-care, necessitating the need for specific transition preparedness programs within the HIV-care cascade to address the peculiar needs of adolescents at this stage.Trial registration: ClinicalTrials.gov identifier: NCT03394391.

Influence of Perception of Family Support and Functioning on Adolescent High-Risk Sexual Behavior.

Adolescents often engage in high-risk behaviors which often have lifelong consequences. It is unclear whether an association exists between adolescents' perception of family support and family functioning and sexual risk behavior. We conducted a cross-sectional study of 702 adolescent students (aged 15-19 years) of a university in Nigeria and assessed high-risk sexual behavior (HRSB) and their judgment of family functioning and support. We used multivariable logistic regression analyses to evaluate the relationship between HRSB and the perception of family support and functioning. We found that 114 (16.2%, 95% CI: 13.69-19.16) of the adolescents engaged in HRSB. A higher proportion of boys (22.7%, 95% CI: 17.79-28.47) than girls (12.93, 95% CI: 10.17-16.31) engaged in HRSB (P = 0.001). The prevalence of intimate partner violence in our study was 8% (95% CI: 6.19-10.29). Participants with lower perception scores were more likely to be engaged in HRSB (aOR: 0.920, 95% CI: 0.878-0.965). Likewise, the perception of family functioning was inversely related to HRSB among the participants (aOR: 0.884, 95% CI: 0.813-0.962). There is an association between adolescents' perception of family support and functioning and HRSB. This association may provide a link in the complex interaction between the role of the family and adolescent sexuality. Programs and interventions for preventing HRSB and promoting risk-reducing autonomous decision-making among adolescents should include context- and setting-specific interventions that improve family support and functioning, and those that target in dysfunctional family settings.

Thanatophoric dysplasia: a case report.

A case of thanatophoric dysplasia with sudden death at term is hereby presented. Thanatophoric dysplasia is an uncommon, lethal skeletal dysplasia which is associated with mutation in the extracellular region of fibroblast growth factor receptor 3 (FGFR3). It is an autosommal dominant condition that has sporadic occurrence and early ultrasound scan has not been of great benefit in its detection. Diagnosis is mostly made in the third trimester. The fetal death is usually due to severe respiratory insufficiency from a reduced thoracic capacity and hypoplastic lungs and/or respiratory failure due to brainstem compression. In view of the autosomal dominance of TD, it will be advisable for a woman with previous history to have prenatal screening to relieve parental anxiety and prevent late detection.