Barriers to Health Care Transition in Adolescents and Young Adults With Early Acquired HIV Infection

• Published in: Contagion Vol. 8; no. 4
• Main Author: Uehling, Megan E
• Format: Journal Article
• Language: English
• Published: Cranbury MultiMedia Healthcare Inc 23.08.2023
• Subjects: Adverse childhood experiences; Caregivers; Child development; Children & youth; Chronic illnesses; Comorbidity; Disclosure; HIV; Human immunodeficiency virus; Infections; Interdisciplinary aspects; Mental disorders; Mental health; Patients; Pediatrics; Post traumatic stress disorder; Stigma; Teenagers; Young adults; United States > US
• ISSN: 1553-538X

In the United States, 1650 cases of perinatal HIV were diagnosed in 1991 at the height of the US epidemic.1 Universal screening of pregnant persons and antiretroviral therapy (ART) resulted in a 95% reduction in new perinatal infections as of 2019.2 Improvements in ART potency, opportunistic infection prophylaxis, and other public health measures have not only decreased the rate of new infections but also decreased childhood mortality associated with EAHIV. [...]children who would have died before adolescence are now reaching early adulthood and beyond. The cumulative effect of ACEs can negatively affect many aspects of an adolescent's life, including physical and mental health.8 A systematic review and meta-analysis from the United Kingdom found that individuals who had at least 4 ACEs growing up were 4 times more likely to experience mental health disease.9 Growing up with a chronic medical condition, many AYA with EAHIV have struggled with frequent illness and hospitalization, particularly prior to the use of combination ART. Important aspects of YFSS include physicians trained in AYA development and care philosophy; accessible care (ie, flexible hours, walk-in services, forgiving late policies, technology for reminders and communication); and on-site, interdisciplinary services (ie, social work, case management, mental health providers).20 Adopting such practices has been shown to facilitate successful transition to the adult care setting.