Department of Epidemiology, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA.
HIV and Special Immunology Services, Children's National Hospital, Washington, District of Columbia, USA.
AIDS Patient Care STDS. 2021 Dec;35(12):495-502. doi: 10.1089/apc.2021.0123.
Transitioning from pediatric to adult services is known to be associated with worsening of health outcomes and decreased retention in care among adolescents and youth living with HIV (AYLHIV). We aimed to identify factors associated with HIV care transition readiness among AYLHIV in care at a pediatric HIV clinic in Washington, DC. This retrospective cohort study from June 2019 through January 2021 collected demographic and clinical characteristics from the clinic database. We adapted the Transition Readiness Assessment Questionnaire (TRAQ; scored 1-4; 1 being the lowest level of preparedness) to evaluate transition readiness over time. We analyzed data using two-sided unadjusted two-sample and paired -tests and adjusted analysis of variance (ANOVA). We included 103 AYLHIV (50.49% female; 100% non-Hispanic Black/African American; mean age = 19.54 ± 2.78 years; 81.55% virally suppressed). Mean baseline TRAQ score (2.32 ± 0.78) was associated with age ( < 0.0001), gender ( = 0.033), mode of HIV transmission ( = 0.0005), viral suppression ( = 0.0033), and duration of HIV diagnosis ( = 0.012). AYLHIV diagnosed with HIV within the prior year experienced significantly greater mean improvement in transition readiness compared with those living with HIV for >10 years ( = 0.013). Adjusted for covariates, older age ( < 0.0001), undetectable viral load ( = 0.0008), and presence of mental health condition(s) ( = 0.020) were associated with higher TRAQ scores. Lower improvement in transition readiness among youth with a longer history of HIV suggests that AYLHIV with perinatally acquired HIV might require additional support than those with horizontally acquired HIV.
从儿科过渡到成人服务已知与艾滋病毒感染者青少年和青年（AYLHIV）的健康状况恶化和护理保留率降低有关。我们旨在确定在华盛顿特区一家儿科艾滋病毒诊所接受护理的 AYLHIV 与艾滋病毒护理过渡准备相关的因素。这项回顾性队列研究于 2019 年 6 月至 2021 年 1 月从诊所数据库中收集了人口统计学和临床特征。我们改编了过渡准备评估问卷（TRAQ；评分 1-4；1 表示最低准备水平）来评估随时间推移的过渡准备情况。我们使用双侧未调整的两样本和配对 t 检验以及调整后的方差分析（ANOVA）分析数据。我们纳入了 103 名 AYLHIV（50.49%为女性；100%为非西班牙裔黑人/非裔美国人；平均年龄为 19.54 ± 2.78 岁；81.55%病毒载量得到抑制）。基线平均 TRAQ 评分（2.32 ± 0.78）与年龄（ < 0.0001）、性别（ = 0.033）、艾滋病毒传播方式（ = 0.0005）、病毒抑制（ = 0.0033）和艾滋病毒诊断持续时间（ = 0.012）相关。在过去一年中被诊断患有艾滋病毒的 AYLHIV 与那些感染艾滋病毒超过 10 年的人相比，过渡准备的平均改善程度显著更高（ = 0.013）。调整协变量后，年龄较大（ < 0.0001）、不可检测的病毒载量（ = 0.0008）和存在精神健康状况（ = 0.020）与 TRAQ 评分较高相关。具有较长艾滋病毒病史的年轻人过渡准备改善程度较低表明，与获得性艾滋病毒的 AYLHIV 相比，经母婴传播获得艾滋病毒的 AYLHIV 可能需要额外的支持。
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