TABLE 1.

Characteristics of Research Articles on Transition among Young People with Perinatal HIV in High Income Countries (HIC)

Studies are ordered firstly by the main outcome investigated, and then alphabetically by country within each geographical region

Author (year)	Country	Design			Mode of infection	Sample size	Median age	Participants			Main outcome	Main finding	Ref
		Qualitative/ semi- struct	Cross- section	Cohort				Patients	Care- givers	Providers
Retention/ loss to follow-up and mortality outcomes, +/− other outcomes and +/− young people’s views
Izzo (2017)	Italy			X	Perinatal	24	18 at transition	X			Retention (not defined), CD4, viral suppression, ART	100% retained 12m post-transition, and 76% 52 months later. 63% (75%) VL<50c/ml at transition (12 months post-transition). Median CD4 was 534 c/mm3 at transition (n=24), 626 c/mm3 1 year later (n=24), and 716c/mm3 52 months later (n=19). Proportion taking integrase inhibitors increased post-transition.	[5]
Sainz (2017)	Spain			X	Perinatal	209	18 at transition	X			Loss to follow-up (not defined), mortality, viral suppression	14% loss to follow-up during or immediately after transition. 4 (2%) died post-transition. 86% who had VL<50c/ml pre-transition remained suppressed post-transition	[6]
Judd (2017)	UK			X	Perinatal	271	17 (last paed visit)	X			Mortality, CD4, viral suppression (two consecutive viral loads>400c/ml or one viral load >10,000 c/ml)	7 (3%) died post-transition. CD4 declined pre-transition, and continued to decline in some groups post-transition. Viral load suppression was similar in the 12 months pre-transfer and post-transfer (53%, 48%)	[7]
Kakkar (2016)	Canada	X		X	Perinatal	25	All transfer to adult care at 18. Mean 22 years at follow-up	X			Retention (≥1 clinic visit within 6 months of interview), CD4	76% were retained a mean of 3.6 years after transition from paediatric to adult care. Mean CD4 decreased from 524 c/mm3 at transfer to 370 one year later. Participants felt that 18 years was too young an age to transfer.	[8]
Hussen (2017)	USA			X	15% perinatal	72	25 (first adult visit)	X			Retention (≥2 visits ≥3 months apart), viral suppression	89% (56%) retained in 1st (2nd) year after transition to adult care. Following transition, those seen sooner in adult care had higher viral suppression.	[9]
					62.5% MSM
					22% heterosex’l
Ryscavage (2016)	USA			X	38% perinatal	50	Perinatal 22 horizontal 25 at transition	X			Retention (≥2 visits over 12 months following linkage (1st adult care visit))	86% were linked to adult care, of whom 58% were retained in adult care at 12 months. Retention was higher in those with perinatal HIV (69%) vs horizontal HIV (52%).	[10]
					62% horizontal
Immunological and virological outcomes
Weijsenfeld (2016)	Netherlands			X	78% perinatal	59	19 at transition	X			Virological, social	Proportion with viral failure increased during transition to adult care vs pre-transition paediatric care. Low education attainment and less autonomy of ART adherence predicted failure.	[11]
Westling (2016)	Sweden			X	91% perinatal	34 at baseline, 29 2 years later	19 at transition	X			Virological, ART	2 years after transfer from paediatric to transition clinic, 90% of 29 were on ART, of which 61% took integrase inhibitors, and 92% had viral load <50c/ml	[12]
Young people’s views
Judd (2017)	UK		X		Perinatal	120	n=38 in paediatric care: 16 yrs	X			Rating of adult care vs paediatric care; readiness to self-manage care	Most rated adult care as better or no different to paediatric care for services and support offered. Those in adult care were better able to self-manage their care.	[13]
							n=82 in adult care: 20 yrs
Provider views
Le Roux (2017)	France	X			Perinatal	18	N/A			X	Transition practices	Adult care providers attempted to adapt their practice to YP with perinatal HIV transferring from paediatric to adult care. Practice depended on the needs of each patient.	[14]
Tanner (2017)	USA	X			Perinatal, horizontal	58	N/A			X	Transition processes, barriers and facilitators; definitions of successful transition	Providers identified components of successful transition from adolescent to adult care. Several structural, clinical and individual factors were identified as transition barriers. Collaborative process of transition from adolescent to adult clinics was recommended to facilitate uninterrupted care	[15–17]
Philbin (2017)
Philbin (2017)
Adolescent and youth friendly services
Griffith (2016)	USA			X	Perinatal, horizontal	132	25	X			Retention (≥6 month gap in care; ≥2 visits ≥90 days apart) at 12 months in youth-targeted care vs adult clinic	A lower proportion of those receiving youth-targeted care had a 6 month gap in care (44% vs 59%) and a higher proportion had 2 appointments ≥90 days apart (83% vs 69%).	[18]
						16/54 receiving youth-targeted care were PHIV
Lee (2016)	USA		X		19% heterosexual, 44% MSM, 35% perinatal or transfusion-acquired	680	25% 15–19	X			Retention in care (≥2 HIV care visits ≥90 days apart within 12 months) stratified by “youth friendly” clinic factors	85% were retained in care overall. After adjustment for demographic and clinical factors, retention was higher in clinics with youth-friendly waiting areas, evening clinic hours, and providers with adolescent health training.	[19]
							75% 20–24