Patient Perspectives on Telehealth for HIV and Mental Health Care at a Pediatric and Adolescent HIV Clinic in Washington, DC.

Despite the scale-up of telehealth for children and youth living with HIV during the COVID-19 pandemic, their experience and interest in continued telehealth use in the future is unknown. We conducted a quality improvement project to identify areas for improvement of telehealth delivery to children and youth living with HIV and evaluate youth's experiences when using telehealth for mental health services. Children and youth living with HIV (up to 24 years) seen at a specialty HIV program during 2020-2021 were surveyed regarding technology access, telehealth knowledge, barriers to telehealth use and interest in future telehealth use for HIV care. Youth (12-<24 years) who used telehealth for mental health services were surveyed regarding their experiences. Data were analyzed using descriptive statistics. Of the 170 patients in care, we surveyed 103 children and youth living with HIV (median age 17.6 years, 88.3% Black, 52.4% female, 77.7% perinatally infected), of whom 69.9% had prior telehealth use for their clinical visit. Most patients had access to a device with internet (99%) and were interested in future telehealth use for HIV care (87.4%). Reasons for not wanting to use telehealth included privacy concerns, distrust, discomfort with telehealth, preferring in-person visits, technology access issues and needing translation services. Most youth (81%) surveyed regarding telehealth for mental health services were satisfied and very likely to recommend it to others. Despite some reported barriers to telehealth, there is a high desirability for continued telehealth use among children and youth receiving HIV care.

Parent perspectives on sexual and reproductive health with internationally adopted youth living with HIV.

Evidence suggests an increasing number of US families are adopting internationally born children with HIV (IACH). Little is known about the experiences of adoptive parents, particularly how they help children navigate adolescence. Many adopted children may have additional needs as they mature into adolescence. Forty-four parents of 51 IACH were recruited from three pediatric infectious disease clinics and social media sites. The majority identified as white (n = 43), Christian (n = 38), and female (n = 43). Mean age of adoptees was 10.1 years (range 3-19, 33 females, 25 from African countries, and Russia, Ukraine, China, Haiti, Columbia, Estonia). Participants completed semi-structured audio-recorded interviews focused on experienced and potential challenges as their child matures. Interviews were coded for emergent themes. Findings identified universal concerns about sexuality. Some parents had not yet discussed sex with their child due to age/level of maturity. Others stated they had "the talk" and some emphasized the importance of abstinence before marriage while others highlighted the importance of comprehensive sex education and open communication. Finally, parents acknowledged that HIV was a manageable illness and hoped their children lived long healthy lives. Medical and mental health clinicians can support families as their child transitions into adolescence.