4
Selecting a Treatment Regimen
HIV-Infected Adolescents and Young Adults
Î Adolescents living with HIV largely belong to two distinct groups—
those who acquired HIV in infancy and are heavily ART-experienced,
and those who acquired HIV more recently during their teens.
Î ART is recommended for all HIV-infected individuals (A-I) to reduce
morbidity and mortality. Thus, ART is also recommended for ART-
naive adolescents. However, before initiation of therapy, adolescents'
readiness and ability to adhere to therapy within their psychosocial
context need to be carefully considered as part of therapeutic decision
making (A-III).
Î Once ART is initiated, appropriate support is essential to reduce
potential barriers to adherence and maximize the success in achieving
sustained viral suppression (A-II).
Î The adolescent sexual maturity rating can be helpful to guide regimen
selection for initiation of or changes in ART as recommended by
either the Adult and Adolescent ART Guidelines or the Pediatric ART
Guidelines. The Adult/Adolescent Guidelines are more appropriate for
postpubertal adolescents (i.e., sexual maturity rating IV or V) (A-III).
Î Pediatric and adolescent care providers should prepare adolescents
for the transition into adult care settings. Adult providers should be
sensitive to the challenges associated with such transitions, consulting
and collaborating with care providers for adolescents with HIV to
ensure adolescents' successful transition and continued engagement
in care (A-III).
