HIV infection in adolescents transitioning to adult care

Adam Bartlett1, Geraldine Dunne1, Alison Curby1, Louise Dolahenty1, Virginia Furner2, Pamela Palasanthiran1

  1. NSW Paediatric HIV Service, Sydney Children’s Hospital, Randwick, NSW
  2. The Albion Centre, Surry Hills, NSW

Last reviewed: March 2020


The majority of adolescents (age 10-19 years) living with HIV have acquired the infection perinatally. As such they have experienced long-term exposure to an interplay of physiologic processes associated with chronic HIV infection and antiretroviral therapy that needs to be managed during a complex period of physical and psychosocial development.[1],[2] This leaves adolescents vulnerable to poorer outcomes compared to children and adults, and HIV care should be provided in specialised services with experienced adolescent health care providers where possible.[3] This cohort, particularly for adolescents from low- and middle-income countries, may experience delays in HIV diagnosis and initiation of optimal combination antiretroviral therapy that could lead to considerable morbidity. These extend beyond opportunistic infections to include impaired growth, delayed puberty, and poor neurocognitive performance.[2],[4],[5] There is also increasing awareness of their susceptibility to mental health and substance use issues.[4],[6],[7] Furthermore, long-term antiretroviral therapy can lead to an array of treatment-related complications that have longer-term implications throughout adulthood.[8]