Adherence to treatment in young people with perinatal HIV infection in the first years after transition from pediatric to the adult medical service

P. Safonova, O. Koltsova
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Abstract

Objective. To assess ART adherence and treatment continuity in young adults living with HIV since birth or childhood in the first years after transition from paediatric to adult service of the AIDS Center, as well as to analyse factors associated with treatment adherence interruption after transition to adult care.Materials and methods. In our study, 86 cases of young people living with HIV since birth or childhood were obtained by chart audit and analyzed, among whom 53.5% were girls and 64.0% lived at home at the time of their 18th birthday, who have been transferred from paediatric to adult care of the AIDS Center for more than one year.Results and discussion. The majority (92%) of young adults living with HIV since birth or childhood retained in the health care system in the first year after the transition, but only 53–62% were highly adherent to treatment and monitoring for HIV infection in the first years after the transition. Episodes of non-adherence to treatment during childhood and adolescence, «more complex» ART scheme and the lack of adult’s social support at the time of 18th birthday increase the likelihood of interruption in treatment adherence in the first year after transition to adult care, while the combination of these factors has negative consequences for adherence and continuity of treatment for a longer period of time.Conclusion. Successful transition from paediatric to adult care for patients living with HIV since birth or childhood requires special additional attention of the health care system, contributes to the health protection of each patient, aims to stop HIV in the second generation.
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从儿科向成人医疗服务过渡后的头几年对围产期艾滋病毒感染青年的治疗依从性
客观的评估艾滋病中心从儿科服务过渡到成人服务后的头几年,感染艾滋病毒的年轻人自出生或儿童时期起的抗逆转录病毒疗法依从性和治疗连续性,并分析过渡到成人护理后与治疗依从性中断相关的因素。材料和方法。在我们的研究中,通过图表审计获得并分析了86例自出生或童年以来感染艾滋病毒的年轻人,其中53.5%是女孩,64.0%在18岁生日时住在家中,他们从儿科转到艾滋病中心的成人护理已经超过一年。结果和讨论。大多数(92%)自出生或儿童时期感染艾滋病毒的年轻人在过渡后的第一年仍留在医疗保健系统,但只有53-62%的人在过渡前几年高度坚持治疗和监测艾滋病毒感染。儿童和青少年时期不坚持治疗的情况、“更复杂”的抗逆转录病毒疗法计划以及18岁生日时缺乏成年人的社会支持,增加了向成人护理过渡后第一年治疗坚持中断的可能性,而这些因素的组合对长期治疗的依从性和连续性具有负面影响。结论为出生或儿童期感染艾滋病毒的患者从儿科护理成功过渡到成人护理,需要卫生保健系统给予特别的额外关注,有助于保护每个患者的健康,旨在阻止第二代感染艾滋病毒。
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来源期刊
HIV Infection and Immunosuppressive Disorders
HIV Infection and Immunosuppressive Disorders Medicine-Infectious Diseases
CiteScore
0.70
自引率
0.00%
发文量
37
期刊介绍: In the scientific-practical journal "HIV Infection and Immunosuppressive Disorders", published various issues of HIV medicine (epidemiology, molecular mechanisms of pathogenesis to the development of educational programs) leading scientists of Russia and countries of CIS, USA, as well as practical healthcare professionals working in research centers, research institutes, universities, clinics where done basic medical work. A special place on the pages of the publication is given to basic and clinical research, analytical reviews of contemporary and foreign reports, the provision of medical care for various diseases.
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