Career and education outcomes among people who acquired HIV perinatally and received care at two tertiary care hospitals in Bangkok, 2014-2020.

Abstract

People born with HIV who receive antiretroviral treatment (ART) are living longer. Data on long-term education and employment among people who acquired HIV perinatally (PAHP) remain limited. We report on the education, employment status, and health outcomes of PAHP attending two tertiary care centers in Bangkok. PAHP ≥14 years of age attending two tertiary care centers in Bangkok were enrolled and participated in the Happy Teen 2 program (HT2), a long-term follow-up comprehensive hospital-based intervention aimed at promoting positive youth development, from June 2014 to December 2015. After completing the HT2 program, PAHP were followed up annually for an additional five years to assess their HIV care outcomes, education, and career paths. Analysis of participants' current education, career levels, and other factors associated with obtaining a college or higher degree in year five (2020) was also conducted. Of the 188 PAHP participants, 149 (79.3%) returned for follow-up. Of these, 83 (55.7%) were female, with a median age of 23.1 years; 129 (86.6%) had good literacy; 12 (8.1%) had learning disabilities; and 2 (1.3%) had physical disabilities. At the 5-year follow-up visit, 95.3% received ART, 85.9% transitioned to adult clinics, 91.1% had a CD4 count ≥200 cells/µl, and 80.0% had a viral load of <50 copies/mL. Regarding education and employment, 75.8% were employed, 30.0% were studying, and 83.0% had completed at least high school (Year 9). PAHP who were married and who consumed alcohol >3 times a week were less likely to seek a higher degree (p-value 0.036 and 0.017, respectively). Conversely, PAHP without disability and who attended HT2-individual sessions only were more likely to pursue higher education beyond Year 12 (p-value 0.005). Most PAHP demonstrated positive health outcomes and achieved a high level of education. Comprehensive care for PAHP that prioritizes personalized guidance and encourages higher education while limiting high alcohol consumption are essential strategies to enhance educational opportunities and career pathways as they transition into adulthood. This study was not registered in a clinical trial registry, as it was not designed as an interventional trial. The program was implemented as part of routine comprehensive care for adolescents with HIV at the participating clinics. This study presents observational findings related to education and career outcomes.