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. 2020 Jan;66(1):92-99.
doi: 10.1016/j.jadohealth.2019.07.025. Epub 2019 Oct 15.

Peritransition Outcomes of Southeast Asian Adolescents and Young Adults With HIV Transferring From Pediatric to Adult Care

Annette H Sohn  1 , Kulkanya Chokephaibulkit  2 , Pagakrong Lumbiganon  3 , Rawiwan Hansudewechakul  4 , Yasmin Mohamed Gani  5 , Lam Van Nguyen  6 , Thahira Jamal Mohamed  7 , Sirinya Teeraananchai  8 , Chuenkamol Sethaputra  9 , Thida Singtoroj  9 , Jintanat Ananworanich  10 , Peter Reiss  11 , Stephen J Kerr  12
Affiliations

Peritransition Outcomes of Southeast Asian Adolescents and Young Adults With HIV Transferring From Pediatric to Adult Care

Annette H Sohn et al. J Adolesc Health. 2020 Jan.

Abstract

Purpose: The aim of this article was to study the clinical and social outcomes of health care transition among Asian adolescents and young adults with HIV (AYHIV).

Methods: AYHIV who transferred from a pediatric to an adult clinic within the past year across five sites in Malaysia, Thailand, and Vietnam had clinical and laboratory evaluations and completed questionnaires about their health, socioeconomic factors, and transition experiences. Multiple logistic regression was used to assess associations with HIV viremia.

Results: Of 93 AYHIV enrolled between June 2016 and April 2017, 56% were female, 87% acquired HIV through perinatal exposure, median age was 20 years (interquartile range [IQR] 18.5-21). Two-thirds were in a formal education program, 43% were employed, 43% of females and 35% of males were sexually active. Median lifetime antiretroviral therapy duration was 6.2 years (IQR 3.3-10.7); 45% had received second-line therapy. Median CD4 was 601 cells/mm3 (IQR 477-800); 82% had HIV-RNA <40 copies/mL. Being in a relationship, a shorter posttransition duration, self-reported adherence of ≥95%, and higher CD4 were inversely associated with HIV viremia. Half felt very prepared for the transfer to adult care, and 20% frequently and 43% sometimes still met with pediatric providers. Two-thirds reported needing to keep their HIV a secret, and 23%-38% reported never or rarely having someone to discuss problems with.

Conclusions: Asian AYHIV in our cohort were concerned about the negative social impact of having and disclosing HIV, and one-third lacked people they could trust with their personal problems, which could have negative implications for their ability to navigate adult life.

Keywords: Adolescent; Asia; HIV; Healthcare transition; Malaysia; Perinatal; Thailand; Vietnam; Young adult.

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Figures

Figure 1.
Figure 1.
Social impact questionnaire responses at enrollment (N=93)
Figure 2.
Figure 2.
Social relationships questionnaire responses at enrollment (N=93)
See this image and copyright information in PMC

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