“…The transition may be particularly challenging for ALWH who are not adequately prepared, with important gaps in life skills and HIV-related knowledge. [ 23 , 24 ] These deficits, along with a low level of caregiver or health provider support, differences in care cultures between pediatric and adult clinics, out-of-pocket expenses, and challenges related to transportation and health insurance, contribute to unsuccessful transitions to adult care. [ 10 , 25 – 29 ] Although retention rates post-transition are heterogenous across settings, they tend to fall well below 95-95-95 targets, and adolescents with evidence of disease progression, unsuppressed viral load, or unstable adherence prior to transition are at particularly high risk of poor outcomes in the post-transition period.…”
We piloted a community-based intervention to improve outcomes among adolescents living with HIV who were transitioning to adult-oriented care in Lima, Peru. We assessed feasibility and potential effectiveness, including within-person changes in self-reported adherence, psychosocial metrics (NIH Toolbox), and transition readiness (“Am I on TRAC” questionnaire, “Got Transition” checklist). From October 2019 to January 2020, we enrolled 30 adolescents (15–21 years). The nine-month intervention consisted of logistical, adherence and social support delivered by entry-level health workers and group sessions to improve health-related knowledge and skills and social support. In transition readiness, we observed within-person improvements relative to baseline. We also observed strong evidence of improvements in adherence, social support, self-efficacy, and stress, which were generally sustained three months post-intervention. All participants remained in treatment after 12 months. The intervention was feasible and potentially effective for bridging the transition to adult HIV care. A large-scale evaluation, including biological endpoints, is warranted.
“…The transition may be particularly challenging for ALWH who are not adequately prepared, with important gaps in life skills and HIV-related knowledge. [ 23 , 24 ] These deficits, along with a low level of caregiver or health provider support, differences in care cultures between pediatric and adult clinics, out-of-pocket expenses, and challenges related to transportation and health insurance, contribute to unsuccessful transitions to adult care. [ 10 , 25 – 29 ] Although retention rates post-transition are heterogenous across settings, they tend to fall well below 95-95-95 targets, and adolescents with evidence of disease progression, unsuppressed viral load, or unstable adherence prior to transition are at particularly high risk of poor outcomes in the post-transition period.…”
We piloted a community-based intervention to improve outcomes among adolescents living with HIV who were transitioning to adult-oriented care in Lima, Peru. We assessed feasibility and potential effectiveness, including within-person changes in self-reported adherence, psychosocial metrics (NIH Toolbox), and transition readiness (“Am I on TRAC” questionnaire, “Got Transition” checklist). From October 2019 to January 2020, we enrolled 30 adolescents (15–21 years). The nine-month intervention consisted of logistical, adherence and social support delivered by entry-level health workers and group sessions to improve health-related knowledge and skills and social support. In transition readiness, we observed within-person improvements relative to baseline. We also observed strong evidence of improvements in adherence, social support, self-efficacy, and stress, which were generally sustained three months post-intervention. All participants remained in treatment after 12 months. The intervention was feasible and potentially effective for bridging the transition to adult HIV care. A large-scale evaluation, including biological endpoints, is warranted.
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