Acree Mary Ellen
Pediatr Ann. 2017 May 1;46(5):e198-e202. doi: 10.3928/19382359-20170424-02.
Remarkable advances have been made in the treatment of HIV. Despite progress in reducing perinatal HIV transmission, there is a growing number of adolescents and emerging adults with HIV who will require transfer of care from pediatric to adult providers. Adolescents with HIV have poorer retention in care and viral suppression compared to other age groups with HIV. Barriers to successful care of youth with HIV include mental health disorders, poor medication adherence, socioeconomic instability, and HIV-related stigma. Transfer of care to adult providers is often met with reluctance on the part of the adolescent. Recommendations for effective transfer of care include clear communication between adult and pediatric providers, early initiation of a transition planning discussion, a multidisciplinary team approach, and meeting the adult provider prior to the transfer of care. Adult HIV care may be more fragmented than adolescents are familiar with, but thoughtful transition approaches can foster development of health and life skills among youth with HIV. [Pediatr Ann. 2017;46(5):e198-e202.].
在HIV治疗方面已经取得了显著进展。尽管在减少围产期HIV传播方面取得了进展，但感染HIV的青少年和刚成年的人越来越多，他们需要从儿科医疗服务提供者转至成人医疗服务提供者处接受治疗。与其他感染HIV的年龄组相比，感染HIV的青少年在接受治疗和病毒抑制方面的持续性较差。为感染HIV的青少年提供成功治疗的障碍包括心理健康障碍、药物依从性差、社会经济不稳定以及与HIV相关的耻辱感。青少年往往不愿意转由成人医疗服务提供者治疗。有效转诊的建议包括成人和儿科医疗服务提供者之间进行清晰的沟通、尽早开始过渡计划讨论、采用多学科团队方法以及在转诊前与成人医疗服务提供者会面。成人HIV治疗可能比青少年熟悉的情况更加分散，但周到的过渡方法可以促进感染HIV的青少年健康和生活技能的发展。[《儿科年鉴》。2017年；46(5):e198 - e202。]
