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TOPLINE:

More than 80% of youth living with HIV in South Carolina transitioned from pediatric to adult care, but fewer than half did so in a timely and sustained manner. Various individual and social factors were linked to the odds of transition.

METHODOLOGY:

• Researchers conducted a retrospective study using 2005-2021 HIV surveillance data from South Carolina to evaluate transitions from pediatric to adult HIV care and factors linked to those transitions.
• They included 658 youth who were diagnosed with HIV infection before the age of 24 years, survived to the age of 20 years, had at least one pediatric visit before the age of 26 years, and had at least 2 years of follow-up care.
• The outcomes were ever transition and successful transition. Ever transition was defined as at least one adult HIV care visit after the last pediatric visit and before the age of 26 years, and successful transition was defined as linkage to adult care within 3 months plus at least two visits or laboratory measures 6 months apart within 1 year.

TAKEAWAY:

• Overall, 81.8% of youth transitioned from pediatric to adult HIV care, and 43.6% of those had a successful transition; the mean age at transition was 21.8 years.
• Transitions were more likely in youth who were older at the time of HIV diagnosis (adjusted odds ratio [aOR], 1.187) and less likely in those with mental health conditions (aOR, 0.276; P < .05 for both).
• Among youth who transitioned, those who acquired HIV infection perinatally were more likely to have a successful transition than those who acquired HIV infection through heterosexual contact (aOR, 4.124; P < .05).
• Unsuppressed viral load and residence in underprivileged counties were associated with lower odds of a successful transition (P < .05 for both).

IN PRACTICE:

“To promote timely and successful HCT [health care transition], tailored transition plans spanning the pretransition (pediatric care), transition, and posttransition (adult care) periods are needed for YWH [youth with HIV] who were diagnosed at a younger age, have a history of mental health conditions, acquired HIV nonperinatally, and reside in economically disadvantaged areas,” the researchers of the study wrote.

SOURCE:

The study was led by Fanghui Shi, PhD, University of South Carolina in Columbia, South Carolina. It was published online on May 5 in the Journal of Adolescent Health.

LIMITATIONS:

Researchers included too few participants with major mental illnesses and could not track those who moved out of South Carolina. They lacked data on food insecurity, on how ready participants felt for transition, or on their psychosocial support.

DISCLOSURES:

The research received support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.