Transition Interventions for Adolescents on Antiretroviral Therapy on Transfer from Pediatric to Adult Healthcare: A Systematic Review

Int J Environ Res Public Health. 2022 Nov 12;19(22):14911. doi: 10.3390/ijerph192214911.

Abstract

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-Individualized care plans, communication, psychological support, and health and sexual education and mHealth-improved adherence, retention in care and viral load suppression at post-transition over the short and long term. In contrast, group transition 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.

Keywords: adherence; adolescents; antiretroviral therapy; retention in care; transition intervention; viral suppression.

Publication types

  • Review
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cross-Sectional Studies
  • Delivery of Health Care
  • HIV Infections* / drug therapy
  • HIV Infections* / psychology
  • Humans
  • Prospective Studies
  • Retrospective Studies
  • Systematic Reviews as Topic
  • Transition to Adult Care*
  • United States

Grant support

This research was funded by the National Research Foundation under a Competitive Support for Unrated Researchers grant (grant numbered 138089).