An adolescent transition package designed to improve the transition to independent care among adolescents and younger adults with HIV infection resulted in overall higher scores in transition readiness, HIV literacy, and self-management assessments, according to study findings published in the Lancet HIV.

Researchers conducted a multicenter, cluster randomized clinical trial, enrolling participants from November 1, 2019 to March 18, 2020 across 4 counties in Kenya. They assessed the effectiveness of an adolescent transition package designed to help participants (age range, 15-24 years) with HIV infection transition to independent care. Enrollment ceased in March 2020 due to restrictions related to the COVID-19 pandemic, but follow-up was successfully completed on June 2, 2021 after modifications were made to the study design to allow telephone delivery for follow-up visits.

The researchers randomly assigned participants across 20 HIV clinics in a 1:1 fashion to receive either the adolescent transition package (n=578; intervention) or standard care (n=488; control). At baseline and after 1 year, clinical trial staff assessed participants’ individual transition readiness scores overall and across 4 domains, including HIV literacy, self-management, communication, and support transition readiness scores of 0, 0.5, and 1 were defined as the lowest, middle, and highest scores, respectively, with scores aggregated by each domain and overall.


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Using student t-testing, overall mean transition readiness scores at baseline were higher among participants in the intervention vs control groups (12.1 vs 11.4; P =.0037).

The researchers used mixed-effects linear regression to compare transition readiness scores between the groups after 1 year, with adjustments for baseline scores, age, and the number of months since HIV status disclosure. Intervention participants demonstrated significantly higher mean readiness scores compared with those in the control group (15.7 vs 13.9, respectively; P =.024). Additionally, participants in the intervention group demonstrated higher mean scores in HIV literacy (4.0 vs 3.0 P =.011) and self-management (4.7 vs 4.4; P =.048).

No significant differences in mean readiness scores were found between intervention and control group participants for the domains of communication or support, though these results may have been affected by restrictions related to the COVID-19 pandemic.

Study limitations include the potential effect of the COVID-19 pandemic on study methods and outcomes, the use of an untested tool to measure transition readiness, possible residual confounding, and the small cluster sample size.

“These results show the effect of intervention delivery, which resulted in a substantial increase in knowledge needed for autonomous HIV care,” the researchers stated. “Integrating [adolescent transition package] approaches could enhance long-term HIV care in youth with HIV as they age into adulthood,” they concluded.

Disclosures: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Njuguna IN, Beima-Sofie K, Mburu CW, et al. Transition to independent care for youth living with HIV: a cluster randomised clinical trial. Lancet HIV. 2022;9(12):e828-e837. doi:10.1016/S2352-3018(22)00244-2

This article originally appeared on Infectious Disease Advisor