School of Public Health, University of the Western Cape, Cape Town 7535, South Africa.
Int J Environ Res Public Health. 2022 Nov 12;19(22):14911. doi: 10.3390/ijerph192214911.
Globally, adolescents living with HIV (ALHIV) experience poor health outcomes such as low retention in care, ART non-adherence and viral non-suppression. These outcomes coincide with the period during and after their transition from pediatric to adult healthcare. This study aimed to systematically describe the compendium of transition interventions and synthesize the effects of such transition interventions on adherence to ART, retention in care and viral load suppression. Seven databases and Google Scholar were searched and the review findings were reported according to the Preferred Reporting Items Stipulated for Systematic Reviews and Meta-Analyses. The risk of bias and the strength of evidence were assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies. Seven studies (two cross-sectional, two retrospective cohort and three prospective cohort studies), with sample sizes ranging from 13 to 192, were included in the narrative synthesis. There was high-quality evidence that these interventions-, and and -improved adherence, retention in care and viral load suppression at post-transition over the short and long term. In contrast, intervention produced weak quality evidence. Hence, transition interventions including a combination of the high-quality evidenced interventions mentioned above can improve treatment outcomes for adolescents on ART.
全球范围内，感染艾滋病毒的青少年（ALHIV）经历着不良的健康结局，如护理保留率低、抗逆转录病毒治疗（ART）不依从和病毒未抑制。这些结果与他们从儿科到成人保健过渡期间和之后的时期相吻合。本研究旨在系统描述过渡干预措施的纲要，并综合评估这些过渡干预措施对 ART 依从性、护理保留率和病毒载量抑制的影响。本研究检索了 7 个数据库和 Google Scholar，并根据系统评价和荟萃分析的规定报告了综述结果。使用美国国立卫生研究院（NIH）针对观察性队列和横断面研究的质量评估工具评估了偏倚风险和证据强度。有 7 项研究（2 项横断面研究、2 项回顾性队列研究和 3 项前瞻性队列研究）纳入了叙述性综合分析，样本量从 13 到 192 不等。有高质量证据表明，这些干预措施在短期和长期的过渡后，在依从性、护理保留率和病毒载量抑制方面都有改善。相比之下，干预措施的证据质量较弱。因此，包括上述高质量证据干预措施的组合的过渡干预措施可以改善接受抗逆转录病毒治疗的青少年的治疗结果。
