Page 125 - HIV/AIDS Guidelines

the importance of prompt symptom recognition and reporting, and the importance of self-efficacy with
medication management, insurance, and entitlements; (4) identifying an optimal clinic model for a given
setting (i.e., simultaneous transition of mental health and/or case management versus a gradual phase-in); (5)
implementing ongoing evaluation to measure the success of a selected model; (6) engaging in regular
multidisciplinary case conferences between adult and adolescent care providers; (7) implementing
interventions that may be associated with improved outcomes, such as support groups and mental health
consultation; and (8) incorporating a family planning component into clinical care. Attention to these key
areas will likely improve adherence to appointments and avert the potential for a youth to “fall through the
cracks,” as it is commonly referred to in adolescent medicine.

References

1. Centers for Disease Control and Prevention (CDC). HIV and AIDS in the United States: A picture of today’s epidemic.
2008; http://www.cdc.gov/hiv/topics/surveillance/united_states.htm
2. Centers for Disease Control and Prevention (CDC). HIV/AIDS surveillance in adolescents and young adults (through
2007). 2009; http://www.cdc.gov/hiv/topics/surveillance/resources/slides/adolescents/index.htm.
3. MMWR. Trends in HIV/AIDS diagnoses among men who have sex with men—33 states, 2001-2006. MMWR Morb
Mortal Wkly Rep. 2008;57(25):681-686.
4. Viani RM, Peralta L, Aldrovandi G, et al. Prevalence of primary HIV-1 drug resistance among recently infected
adolescents: a multicenter adolescent medicine trials network for HIV/AIDS interventions study. J Infect Dis.
2006;194(11):1505-1509.

5. Grubman S, Gross E, Lerner-Weiss N, et al. Older children and adolescents living with perinatally acquired human
immunodeficiency virus infection. Pediatrics. 1995;95(5):657-663.

6. Rogers A (ed). Pharmacokinetics and pharmacodynamics in adolescents. J Adolesc Health. 1994;15:605-678.
7. El-Sadar W, Oleske JM, Agins BD, et al. Evaluation and management of early HIV infection. Clinical Practice Guideline
No. 7 (AHCPR Publication No. 94-0572). Rockville, MD: Agency for Health Care Policy and Research, Public Health
Service, US Department of Health and Human Services, 1994.
8. Buchacz K, Rogol AD, Lindsey JC, et al. Delayed onset of pubertal development in children and adolescents with
perinatally acquired HIV infection. J Acquir Immune Defic Syndr. 2003;33(1):56-65.
9. Working Group on Antiretroviral Therapy and Medical Management of HIV-Infected Children. Guidelines for the use of
antiretroviral agents in pediatric HIV infection. August 16, 2010:1-219.
http://aidsinfo.nih.gov/contentfiles/PediatricGuidelines.pdf.
10. Lyon ME, Trexler C, Akpan-Townsend C, et al. A family group approach to increasing adherence to therapy in HIV-
infected youths: results of a pilot project. AIDS Patient Care STDS. 2003;17(6):299-308.
11. Brooks-Gunn J, Graber JA. Puberty as a biological and social event: implications for research on pharmacology. J
Adolesc Health. 1994;15(8):663-671.
12. Kyngas H, Hentinen M, Barlow JH. Adolescents' perceptions of physicians, nurses, parents and friends: help or
hindrance in compliance with diabetes self-care? J Adv Nurs. 1998;27(4):760-769.
13. La Greca AM. Peer influences in pediatric chronic illness: an update. J Pediatr Psychol. 1992;17(6):775-784.
14. Murphy DA, Wilson CM, Durako SJ, et al. Antiretroviral medication adherence among the REACH HIV-infected
adolescent cohort in the USA. AIDS Care. 2001;13(1):27-40.
15. Stenzel MS, McKenzie M, Mitty JA, et al. Enhancing adherence to HAART: a pilot program of modified directly
observed therapy. AIDS Read. 2001;11(6):317-319, 324-318.
16. Purdy JB, Freeman AF, Martin SC, et al. Virologic response using directly observed therapy in adolescents with HIV: an
adherence tool. J Assoc Nurses AIDS Care. 2008;19(2):158-165.

Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents I-9

Downloaded from http://aidsinfo.nih.gov/guidelines on 12/8/2012 EST.