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The Challenge of and Opportunities for Transitioning and Maintaining a Continuum of Care Among Adolescents and Young Adults Living with HIV in Resource Limited Settings

  • HIV in the Tropical Setting (B Morawski and A Kambugu, Section Editors)
  • Published:
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Abstract

Purpose of Review

An unprecedented number of youth living with HIV (YLHIV) are aging into adolescence and young adulthood, increasing concerns about the possibility of these youth being lost in the transition from supported care (sometimes in pediatric settings) to more independent healthcare settings. This could further the emerging disparities in outcomes between YLHIV and adults (e.g., higher nonadherence to treatment and increased viral loads, which may result in increased transmission of resistant HIV strains and increased morbidity and mortality).

Recent Findings

In resource-rich settings where there is likely greater recognition of adolescent cognitive and developmental challenges, transitioning YLHIV to adult healthcare has emerged as a major challenge. In resource-limited settings (RLS), where the burden of HIV is significant and healthcare resources often stretched, the challenge to move toward healthcare independence and maintain a fluid continuum of care for YLHIV may be the greatest.

Summary

We review key issues in transitioning YLHIV in RLS, highlighting steps in the transition process, examining evidence where available, and discussing challenges and opportunities to understanding and optimizing outcomes.

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Authors and Affiliations

  1. Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Jennifer Jao

  2. Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Jennifer Jao

  3. Wits Reproductive Health & HIV Research Institute, University of the Witwatersrand, Johannesburg, South Africa

    Lee Fairlie

  4. Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA

    David C. Griffith & Allison L. Agwu

  5. Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA

    David C. Griffith & Allison L. Agwu

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  1. Jennifer Jao
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  2. Lee Fairlie
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  4. Allison L. Agwu
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Corresponding author

Correspondence to Allison L. Agwu.

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Conflict of Interest

Jennifer Jao declares grant support from the National Institute of Child Health and Development and National Institute of Diabetes and Digestive and Kidney Diseases (K23HD070760 and R01DK109881).

Lee Fairlie declares grant support from the NIAID (IMPAACT site) and USAID/PEPFAR (funding grant for HSS and AIP).

David Griffith declares grant support from the Pediatric Infectious Diseases Training Grant (T32 AI052071).

Allison L. Agwu declares grant support from the Johns Hopkins Center for AIDS Research (1P30AI094189) as well as from the NICHD (IMPAACT site and Adolescent trials network site) and NIAID (Career Development Award (K23)).

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on HIV in the Tropical Setting

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Jao, J., Fairlie, L., Griffith, D.C. et al. The Challenge of and Opportunities for Transitioning and Maintaining a Continuum of Care Among Adolescents and Young Adults Living with HIV in Resource Limited Settings. Curr Trop Med Rep 3, 149–157 (2016). https://doi.org/10.1007/s40475-016-0091-1

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  • DOI: https://doi.org/10.1007/s40475-016-0091-1

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