Adolescents transitioning to adult care

Adam Bartlett1, Geraldine Dunne1, Alison Curby1, Louise Dolahenty1, Virginia Furner2, Pamela Palasanthiran1 NSW Paediatric HIV Service, Sydney Children’s Hospital, Randwick, NSW The Albion Centre, Surry Hills, NSW Last reviewed: March 2020 Introduction The majority of adolescents (age 10-19 years) living with HIV have acquired the infection perinatally. As such they have experienced long-term exposure to …

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Sharing knowledge of a young person’s HIV status with them should be an incremental process that needs to take into account their cognitive skills and emotional maturity, as well as their caregiver’s views about and knowledge of HIV infection. Generally, this begins with education about the immune system and how certain viruses can damage the …

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Most adolescents will have commenced ART during earlier childhood and will transition to a fixed-dose combination (FDC) regimen during early adolescence. The FDC regimen chosen will depend upon comorbidities, potential for drug-drug interactions (e.g., with oral contraceptives), prior antiretroviral drug exposure, antiretroviral drug resistance profiles, and any antiretroviral drug intolerances. There is increasing evidence and …

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Adolescents face many challenges that can affect their psychosocial wellbeing. These include: the capacity for independence and self-management; an understanding of and ability to cope with potential stigma or discrimination; dealing with family stress, illness or death, orphanhood, and poverty; progress through education with possible cognitive impairment; disclosure to others for emotional and practical support; …

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Strategies to develop health independence should be a continual process throughout adolescence. This involves a more sophisticated understanding of HIV infection and the health issues arising from this, including HIV viral loads, CD4+ T counts, ART adherence, implications of antiretroviral drug resistance, and viewing HIV infection as a chronic condition that can be easily controlled …

Developing health independence Read More »

Transition from paediatric to adult HIV services should be a planned multifaceted process designed to maintain engagement in care, facilitate adolescent health autonomy, maximise adolescent and family satisfaction, and optimise health outcomes. The model of transition will be determined by the availability of services, but should at least involve an integrated process incorporating adolescent and …

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Adolescents who acquire HIV infection during adolescence (ie., by horizontal rather than vertical transmission) follow a similar clinical course to that of adults. Antiretroviral therapy should be commenced as soon as practical provided the young person is willing to adhere to therapy.[12],[13] Initial ART regimens are likely to be focused on simplification, given that the …

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References Hazra R, Siberry GK, Mofenson LM. Growing up with HIV: children, adolescents, and young adults with perinatally acquired HIV infection. Annu Rev Med, 2010; 61:169-185 Vreeman RC, Scanlon ML, McHenry MS, Nyandiko WM. The physical and psychological effects of HIV infection and its treatment on perinatally HIV-infected children. J Int AIDS Soc, 2015; 18(Suppl …

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