Pediatrics. 2014 Mar;133(3):558-62. doi: 10.1542/peds.2013-4061. Epub 2014 Feb 24.
This clinical report provides guidance for the pediatrician in addressing the psychosocial needs of adolescents and young adults living with HIV, which can improve linkage to care and adherence to life-saving antiretroviral (ARV) therapy. Recent national case surveillance data for youth (defined here as adolescents and young adults 13 to 24 years of age) revealed that the burden of HIV/AIDS fell most heavily and disproportionately on African American youth, particularly males having sex with males. To effectively increase linkage to care and sustain adherence to therapy, interventions should address the immediate drivers of ARV compliance and also address factors that provide broader social and structural support for HIV-infected adolescents and young adults. Interventions should address psychosocial development, including lack of future orientation, inadequate educational attainment and limited health literacy, failure to focus on the long-term consequences of near-term risk behaviors, and coping ability. Associated challenges are closely linked to the structural environment. Individual case management is essential to linkage to and retention in care, ARV adherence, and management of associated comorbidities. Integrating these skills into pediatric and adolescent HIV practice in a medical home setting is critical, given the alarming increase in new HIV infections in youth in the United States.
本临床报告为儿科医生提供了指导，以满足感染 HIV 的青少年和年轻成年人的社会心理需求，从而改善他们与护理的联系，并提高对救命的抗逆转录病毒 (ARV) 治疗的依从性。最近针对青年（此处定义为 13 至 24 岁的青少年和年轻人）的全国病例监测数据显示，艾滋病毒/艾滋病的负担主要且不成比例地落在非裔美国青年身上，特别是男男性行为者。为了有效增加与护理的联系并维持对治疗的依从性，干预措施应针对 ARV 依从性的直接驱动因素，并解决为感染艾滋病毒的青少年和年轻人提供更广泛的社会和结构性支持的因素。干预措施应解决社会心理发展问题，包括缺乏未来导向、教育程度不足和有限的健康素养、未能关注近期风险行为的长期后果，以及应对能力。相关挑战与结构环境密切相关。个体病例管理对于与护理的联系和保留、ARV 依从性以及相关合并症的管理至关重要。鉴于美国青年中新感染艾滋病毒的人数令人震惊地增加，将这些技能整合到儿科和青少年艾滋病毒医疗实践中至关重要。
