Journal of Adolescent Health最新文献

{"title":"Variability in Health Outcomes According to Pediatric to Adult Transfer-of-Care Status Among Young Adults With Sickle Cell Disease.","authors":"Tarun Aurora, Emilia Nascimento, Patricia Moura, Heloisa Helena Miranda, Thais Oliveira, Nick Faris, Ana A Baumann, Jane S Hankins, Clarisse Lobo","doi":"10.1016/j.jadohealth.2025.01.023","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.01.023","url":null,"abstract":"<p><strong>Purpose: </strong>Transitioning from pediatric to adult care is critical for young adults with sickle cell disease. While the transfer typically occurs at age 18, some pediatric providers continue care into adulthood. This study evaluates whether remaining in pediatric care versus transferring to adult care affects health outcomes. We hypothesized that those who remain in pediatric care after age 18 would experience fewer acute health-care events and better outcomes than those who transfer to adult care.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at HEMORIO, a blood center in Rio de Janeiro, Brazil. Health-care utilization (outpatient visits, emergency department visits, hospitalizations), hydroxyurea use, care abandonment, and mortality were compared among young adults with sickle cell disease aged 18-23 under pediatric or adult care. Wilcoxon rank sum tests and Fisher's exact tests were used for statistical analysis.</p><p><strong>Results: </strong>Among 472 eligible patients (50% female, 71% Hb SS or Hb Sβ0 thalassemia), 81 (17%) remained in pediatric care, while 391 (83%) transferred to adult care. After age 18, patients in pediatric care had fewer emergency visits and hospitalizations compared to those in adult care. Transferred patients showed increased emergency visits and hospitalizations relative to their adolescent period, whereas those remaining in pediatric care experienced reduced rates of these events.</p><p><strong>Discussion: </strong>Transitioning to adult care is associated with increased adverse outcomes despite more frequent ambulatory visits. Enhancing transition programs to improve adult care integration and engagement is essential to address these disparities.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines on the Inclusion and Protection of Adolescent Minors and Young Adults in Health Research: A Position Statement of the Society for Adolescent Health and Medicine.","authors":"","doi":"10.1016/j.jadohealth.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.02.007","url":null,"abstract":"<p><p>These guidelines aim to assist researchers and research ethics committees/institutional review boards in the ethical conduct of health research with adolescents and young adults (AYA), particularly research with adolescent minors. Inclusion of AYA in research and protection from research harms are essential if, as individuals and as a group, they are to receive the benefits of research. The ethical principles of respect for persons, beneficence, and justice, the human rights concepts of best interests and emerging capacity, and the concept of appropriate inclusion collectively provide an ethical framework for evaluating the circumstances within which adolescent minors can and should be involved as research participants. Likewise, legal concepts guiding informed consent in health-care practice-age of majority, emancipation, mature minor, and minor consent-provide an important conceptual basis for informed consent with adolescents in health research. Consent processes in adolescent health research should be based on scientific understandings of AYA cognitive, psychological, and social development; the weight of current scientific evidence suggests that capacity to provide informed consent for research is present by the age of 14 years. When adolescent minors consent for themselves (i.e., autonomously or independent of parents/guardians), procedures should be in place to assess and support their desire for advice from parents and other trusted adults. Researchers should involve AYA in the codesign of research and should involve community members, parents, and AYA in the development of research priorities and questions, to ensure that research is relevant to AYA, to protect privacy and confidentiality, to facilitate the dissemination of research findings, and to promote translation of research into practice. Research with AYA should never reinforce stigma and discrimination of AYA or the groups to which they belong.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity is Related to Lower Levels of Neurofilament Light and Plasma Tau Protein: A 22-Year Follow-Up Study From Adolescence to Adulthood.","authors":"Yasmin Ezzatvar, José Francisco López-Gil, Rodrigo Yáñez-Sepúlveda, Jorge Olivares-Arancibia, Jacqueline Páez-Herrera, Antonio García-Hermoso","doi":"10.1016/j.jadohealth.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.02.003","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association between physical activity (PA) and neurodegeneration biomarkers from adolescence to adulthood by examining tau protein and neurofilament light chain (NfL) levels in blood samples.</p><p><strong>Methods: </strong>The study analyzed data from adolescents aged 12-19 years who participated in Waves I (1994-1996) and V (2016-2018) of the Add Health study over a span of 22 years. It assessed PA through self-reported questionnaires. Neurodegeneration measures at Wave V used venous blood collected via phlebotomy. Samples were analyzed using single-molecule array (Simoa) technology on a Quanterix HD-1 analyzer, using digital enzyme-linked immunosorbent assay to quantify NfL and tau proteins from serum and plasma samples.</p><p><strong>Results: </strong>In the present study, 3,182 individuals participated, with females comprising 61% of the sample. Participants adhering to the PA guidelines in both waves reported lower levels of NfL (-0.583 pg/mL, 95% bias-corrected and accelerated (BCa) confidence interval (CI): -1.235 to -0.068) and tau protein levels (-0.244 pg/mL, 95% BCa CI: -0.405 to -0.078). Adjusted analyses confirmed significant lower levels of tau protein (-0.210 pg/mL, 95% BCa CI: -0.350 to -0.072) for Wave I adherents and even lower levels in NfL (-0.421 pg/mL, 95% BCa CI: -0.929 to -0.007) and tau protein levels (-0.229 pg/mL, 95% BCa CI: -0.412 to -0.053) for active participants in both waves.</p><p><strong>Discussion: </strong>Our findings suggest that consistent engagement in PA may reduce certain neurodegenerative biomarkers, potentially influencing neurological health outcomes.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation and Management of Children and Young People Referred to a Paediatric Tertiary Post-COVID Service.","authors":"Anne-Lise Goddings, Rebecca Johnston, Elizabeth Wortley, Ria Patel, Holly Boyd, Fiona Newlands, Roz Shafran, Benjamin Baig, Elizabeth Whittaker, Terry Y Segal","doi":"10.1016/j.jadohealth.2025.01.026","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.01.026","url":null,"abstract":"<p><strong>Purpose: </strong>Post-COVID condition (PCC) emerged following the 2020 coronavirus pandemic and required rapid service development to manage affected patients. This evaluation describes the demographics, medical background, management and six-month outcomes of children and young people with PCC-related symptoms referred to one specialist tertiary service between June 2020 and August 2022.</p><p><strong>Methods: </strong>Data were retrospectively collected from referral information and medical notes.</p><p><strong>Results: </strong>176 patients (61% female) aged 6-18 years were referred, with a mean 8.2 PCC-related symptoms impacting on functioning (97%) and school attendance (86%). 10% patients had an autistic spectrum disorder diagnosis, above the ∼2% national prevalence, while rates of atopy and mental health were similar to national prevalence. 59% patients were managed in specialist tertiary clinics by clinicians with input from allied health professionals. At 6 month review, 40/73 patients reported improvement in their daily functioning, with 30/73 reporting no change and 3/73 reporting functional deterioration. School attendance increased over 6 months for 43/67 patients, with 12/67 reporting no change and 4/67 reporting reduced school attendance.</p><p><strong>Discussion: </strong>Patients referred for PCC-related specialist input have significant functional impairment and challenges accessing education. More than half of those seen in specialist clinics showed functional improvement and increased school attendance over 6 months, while a subgroup had persistent symptoms. This suggests that the service model is beneficial for this complex patient group overall, although needs to be resourced for longer input for some. Further work is needed to understand the variability in presentation and symptom course.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Childhood Experiences are Associated With the Timing of Puberty in Girls but Not in Boys.","authors":"Ai Kubo, Sara Aghaee, Julia Acker, Julianna Deardorff","doi":"10.1016/j.jadohealth.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.02.009","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the associations between adverse childhood experiences (ACEs) scores from routine screenings in pediatric checkups and timing of puberty in a diverse cohort of adolescents.</p><p><strong>Methods: </strong>A retrospective cohort study of 52,573 pediatric members of Kaiser Permanente Northern California, an integrated healthcare delivery system. Exposure was the total ACEs score, determined using caregiver- and self-reported scores across all well-child visits, and categorized into 0, 1-3, 4-6, or 7-10 ACEs. Outcomes were age at menarche and pubertal onset, using physician-assessed Sexual Maturity Ratings.</p><p><strong>Results: </strong>Girls with ACEs had a substantially higher risk of earlier menarche and pubertal onset compared to those without ACEs. There were no associations between ACEs and boys' pubertal timing.</p><p><strong>Discussion: </strong>These results highlight the importance of screening for ACEs in a clinical setting to address adolescents' psychological well-being and healthy lifestyle habits, which in turn may prevent adverse health outcomes associated with early puberty.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transgender Youth's Perspectives on the Relationships Between Pregnancy, Contraceptives, and Dysphoria.","authors":"A J Lowik, Shams M F Al-Anzi, Ace Chan, Michele Ybarra, Elizabeth Saewyc","doi":"10.1016/j.jadohealth.2025.01.024","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.01.024","url":null,"abstract":"<p><strong>Purpose: </strong>To explore how trans youth with pregnancy capacity think through and understand the associations between pregnancy, contraception methods, and dysphoria.</p><p><strong>Methods: </strong>We conducted 8 asynchronous online focus groups (n = 152) between 2020 and 2021 with trans youth assigned female at birth, and thus presumed capable of pregnancy, aged 14-18, who were living in the United States. Data were analyzed using a qualitative thematic approach informed by interpretive description.</p><p><strong>Results: </strong>Some youth participants were unequivocal in their belief that both pregnancy and contraception would give rise to gender-related distress, which affected how they framed the acceptability of pregnancy and various methods for its prevention. Others had more dynamic understandings of dysphoria, recognizing that it is not inevitable or uniformly experienced. Still others posited that dysphoria that does occur can be managed considering the individual's priority goal or desire - whether to become a gestational parent or to prevent pregnancy. Participants discussed the importance of accessing sexual and reproductive healthcare, even if doing so requires them to navigate terrains of potential dysphoria, including dysphoria that is provoked by having to access gendered spaces and services and due to the use of gendered language.</p><p><strong>Discussion: </strong>Youth participants had varied, nuanced understandings of dysphoria and its potential impact on their conception, pregnancy, and contraception experiences. Many did not hold prescriptive views that dysphoria is a defining aspect of their lives as trans people. Findings suggest strategies for the delivery of gender-affirming, youth-friendly sexual and reproductive healthcare that attends to dysphoria-as-distress when it occurs.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Childhood Experiences and Unmet Health Care Needs due to Cost and the COVID-19 Pandemic: A Nationally Representative Analysis of U.S. Adolescents.","authors":"Rohan Khazanchi, Ryan C L Brewster, Destiny G Tolliver, Nia J Heard-Garris, Aditi Vasan, Tyler N A Winkelman, Scott E Hadland","doi":"10.1016/j.jadohealth.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.02.001","url":null,"abstract":"<p><strong>Purpose: </strong>Adverse childhood experience (ACE) exposure and poor mental health are closely intertwined. In 2020, the prevalence of both began precipitously increasing among adolescents. We explored associations of individual and cumulative ACE exposure with cost and COVID-19 pandemic-related unmet health needs to assess ACEs as risk markers for broader structural adversity.</p><p><strong>Methods: </strong>We conducted a nationally representative analysis of 5,536 adolescents (weighted N = 20,294,070) aged 13-17 years using the 2019 and 2021 National Health Interview Survey. Outcomes included mental health symptoms, preventive care access, cost and COVID-19-related unmet needs, and health care use. We estimated associations with lifetime exposure to 4 ACEs using marginal effects from multivariable logistic regressions.</p><p><strong>Results: </strong>Millions of adolescents were exposed to parental incarceration (7.8%, N = 1,407,670), neighborhood violence (6.9%, N = 1,567,483), a guardian with serious mental illness (10.3%, N = 2,088,957), and/or a guardian with alcohol or drug problems (11.4%, N = 2,304,953). Overall, 77.7% (N = 15,758,023), 13.2% (N = 2,671,342), and 9.2% (N = 1,864,704) were exposed to 0, 1, and 2+ of these ACEs. In adjusted models, compared with exposure to 0 ACEs, exposure to 1 or 2+ ACEs was positively associated with anxiety and depression symptom frequency, urgent care and emergency department use, trouble paying medical bills, delayed and forgone mental health care due to cost, and delayed and forgone care due to the COVID-19 pandemic.</p><p><strong>Discussion: </strong>Adolescents exposed to ACEs experienced mutually reinforcing disadvantages: a worse mental health symptom burden, yet greater barriers to accessing needed medical and mental health care. ACEs must be reconceptualized as markers of structural-rather than individual-adversity and addressed through structural and policy interventions.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Promising Message Themes for Youth Who Use Multiple Tobacco Products.","authors":"Sarah D Kowitt, Seth M Noar, Isabelle Duguid, Meg Johnson, Allison J Lazard, James F Thrasher, Adam O Goldstein","doi":"10.1016/j.jadohealth.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.02.004","url":null,"abstract":"<p><strong>Purpose: </strong>While most tobacco prevention and cessation ads focus on a single product, little research exists on developing campaigns to influence youth who use multiple tobacco products (MTPs).</p><p><strong>Methods: </strong>To examine the effects of message themes in ads targeting MTP use, we conducted an online within-subjects experiment with n = 310 US youth (ages 13-20) who reported past 30-day vaping and smoking cigarettes or cigars. Participants were randomly assigned to rate 6 messages from different themes about the consequences of vaping and smoking (e.g., \"Vaping and smoking can lead to anxiety and irritability\") from a pool of 49 messages.</p><p><strong>Results: </strong>Regarding intended effects, all message themes performed significantly better than control on perceived message effectiveness (PME) (p < .01). In addition, themes about chemical exposures and health effects on organs with explanations for how health effects occurred led to higher PME than most other themes (including health effects on organs without explanations), while the nicotine addiction theme led to lower PME than most other themes (p < .05). Regarding unintended effects, health effects on organs with explanations led to a greater likelihood of thinking vaping is more harmful than smoking versus control (p < .05), although unintended effects were smaller than intended effects.</p><p><strong>Discussion: </strong>Themes about chemical exposures and health effects on organs with explanations were perceived as more effective than other themes for ads targeting youth who use MTPs. However, health effects on organs with explanations also increased vaping relative harm, and future research is needed to examine any potential unintended consequences on behavior from such messaging.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual and Reproductive Health and Rights.","authors":"","doi":"10.1016/j.jadohealth.2025.02.008","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.02.008","url":null,"abstract":"<p><p>Sexual and reproductive health is a fundamental human right for all people, including adolescents and young adults (AYAs). Sexual and reproductive health and rights (SRHR) encompasses the right to comprehensive, medically accurate, and evidence-based sexual health information and healthcare services, as well as the ability to understand and exercise these rights. SRHR are essential to AYA's emotional, cognitive, and psychosocial development, physical and mental health, gender equality, and wider economic and social development. Access to sexual and reproductive health information and healthcare, inclusive of sexual orientation, gender identity, sexual behavior, and reproduction, is critical to achieving healthy sexual development. A strong body of research demonstrates that access to comprehensive, confidential sexual and reproductive health education and healthcare services, as well as family and community supports, improves a range of outcomes for AYAs. These favorable outcomes include delays in the age of sexual debut, reductions in sexual activity rates and the number of sexual partners, and increases in contraception and condom use. While there have been significant advancements in SRHR across the globe, AYAs continue to experience disproportionately higher rates of sexually transmitted infections, human immunodeficiency virus, unintended pregnancy, reproductive coercion, and sexual exploitation, as well as violence based on sex assigned at birth, sexual orientation, and gender identity. These disparities contribute to morbidity, mortality, and health inequities. Accordingly, the Society for Adolescent Health and Medicine adopts the following positions: (1) comprehensive sexual and reproductive health information and healthcare are fundamental human rights for all AYAs; (2) all AYAs should have universal access to comprehensive sexual and reproductive health information and healthcare; (3) all AYA-serving clinicians should have requisite knowledge and skills to provide sexual and reproductive health information and healthcare, and nonclinical AYA professionals should be an SRHR resource and provide referrals; and (4) increased investments in AYA-related sexual and reproductive health education, services, research, and advocacy, with meaningful stakeholder engagement, are needed to actualize SRHR for AYAs. Further, AYAs should have a voice in SRHR interventions and policies that affect their lives to ensure these efforts are relevant and meet their needs. Opportunities to advance the SRHR of AYAs exist at each level of the socioecological system.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operation Triple Zero: Implementation, Processes, and Outcomes of an Asset-Based Approach to Achieving Viral Suppression Among Adolescents and Young Persons Living With HIV in Kenya, 2017-2021.","authors":"Immaculate Mutisya, Anthony Waruru, Raphael Ondondo, Lennah Omoto, Susan Hrapcak, Jessica Gross, Deborah Carpenter, George Odingo, Davies Kimanga, Stella Njuguna, Odylia Muhenje, Evelyn Ngugi, Abraham Katana, Lucy Ng'ang'a","doi":"10.1016/j.jadohealth.2024.12.017","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2024.12.017","url":null,"abstract":"<p><strong>Purpose: </strong>The 2018 Kenya Population-based HIV Impact Assessment revealed gaps in HIV care among adolescents and young people living with HIV (AYPLHIV) aged 10-24 years, with only 70.6% aware of their status, of these, 93.1% on antiretroviral therapy (ART), and 79.2% of those on treatment had achieved viral load suppression (VLS). Operation Triple Zero (OTZ) aims to address these gaps by fostering intrinsic motivation in AYPLHIV to achieve good health outcomes, emphasizing zero missed appointments, zero missed medication, and zero viral load. We examine clinical outcomes of VLS, ART adherence, and retention among AYPLHIV aged 10-24 enrolled in OTZ from 2017 to 2021.</p><p><strong>Methods: </strong>Data from 20 early adopter OTZ sites were analyzed for ART adherence, retention, viral load testing, and VLS. We compared demographic and clinical characteristics at enrollment and end line by sex, using Pearson's chi-square test for categorical variables, McNemar chi-square test, and Wilcoxon rank-sum for baseline versus end-line comparisons.</p><p><strong>Results: </strong>Of 1,569 AYPLHIV enrolled in OTZ, 1,372 (87.4%) had complete records. The median age at OTZ enrollment was 12 years (interquartile range: 14-16). VLS improved from 72.7% to 88.5% (p < .001), and 96% of AYPLHIV were retained on ART. Among virally suppressed AYPLHIV at baseline (n = 958), 92.4% sustained VLS (91.9% females, 92.9% males), notably 100% among those on once-a-day dolutegravir or atazanavir. Re-suppression rate for viremic AYPLHIV at baseline (n = 360) was 78.3%. Satisfactory adherence correlated with higher re-suppression rates.</p><p><strong>Discussion: </strong>OTZ implementation led to improved HIV treatment outcomes among AYPLHIV, contributing to sustained epidemic control efforts complementing other interventions.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}