Transition From Adolescent to Adult Care for Young People Living With HIV: A Systematic Review of Needs, Barriers, and Interventions.

Young people living with HIV (YPLHIV) aged 15-24 years represent over 25% of new HIV infections globally. They face significant challenges in transitioning from pediatric to adult care. Despite guidelines from major health organizations, many YPLHIV experience unstructured transitions, leading to gaps in care and reduced viral suppression. This systematic review examines barriers and facilitators during this transition and evaluates interventions aimed at improving the transition to adult care for YPLHIV. This systematic review follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, with searches conducted in PubMed, Embase, and key conference abstracts from 2000 to 2024. Our search generated 1,451 articles and 17 conference abstracts, which were screened and manually searched to yield 89 studies and 10 conference abstracts. These were further categorized into 64 descriptive studies and 35 intervention studies, with 33 reporting results. Literature on YPLHIV transitioning to adult care mainly explores stakeholders' perceptions of barriers. Less than one third of studies discuss interventions, with fewer assessing their feasibility, acceptability, or efficacy. Our review highlights interventions like transition readiness assessments, protocols, skills-building, transition clinics, youth-friendly services, mobile health, and health navigation. This review reveals a critical need for future randomized controlled trials to evaluate long-term outcomes and establish effectiveness in improving YPLHIV's transition outcomes.