Adolescents with perinatally acquired HIV: emerging behavioral and health needs for long-term survivors
Adolescents with perinatally acquired HIV: emerging behavioral and health needs for long-term survivors
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DOI：
10.1097/gco.0b013e32834a581b
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发表时间：
2011-10-01
影响因子：
2.1
通讯作者：
Abramowitz, Susan
中科院分区：
文献类型：
--
作者：
Koenig, Linda J.;Nesheim, Steven;Abramowitz, Susan
综述的目的由于高效抗逆转录病毒疗法在发达国家的广泛应用，很大一部分通过围产期感染艾滋病毒的儿童存活到了青春期和青春期。尽管他们的存活率很高，但许多人现在经历了艾滋病毒感染及其治疗的长期影响。此外，随着这些年轻人进入青春期，人们对正常发育转变对健康维持行为的影响有了更多的了解。最近的发现尽管围产期感染的青少年比十年前或十多年前更健康，但他们在抗逆转录病毒治疗方面经验丰富，病毒学抵抗力增强，以及长期使用抗逆转录病毒的其他后果。在第一批长期幸存者中记录了三个行为健康挑战：服药依从性降低，首次性行为和伴随怀孕和传播风险，以及心理健康问题。这些问题与要求自主、成熟的性关系和未来规划的发展压力是一致的，但必须谨慎管理，以维护健康。摘要患有围产期感染艾滋病毒的青少年需要协调的多学科支持服务，包括坚持支持、针对怀孕计划和疾病传播的生殖健康咨询，以及心理健康和教育/职业规划-以便他们能够充分受益于治疗进展。
Purpose of reviewBecause of widespread availability of highly active antiretroviral therapy in the developed world, a large proportion of children with perinatally acquired HIV have survived to adolescence and young adulthood. Although their survival is remarkable, many now experience the long-term effects of HIV infection and its treatment. Further, as these youths have entered adolescence, more is known about the impact of normative developmental transitions on health maintenance behaviors.Recent findingsAlthough perinatally infected adolescents are healthier than they were a decade or more ago, they are significantly experienced with antiretroviral therapy, with increased virological resistance and other consequences of extended antiretroviral use. Three behavioral health challenges have been documented in the first cohort of long-term survivors: decreased medication adherence, sexual debut and accompanying pregnancy and transmission risk, and mental health problems. These issues are consistent with a developmental press for autonomy, mature sexual relationships and future planning, but must be carefully managed to preserve health.SummaryAdolescents with perinatally acquired HIV require coordinated multidisciplinary support services - including adherence support, reproductive health counseling addressing both pregnancy planning and disease transmission, and mental health and educational/vocational planning - so that they can fully benefit from treatment advances.