title: Adolescents with perinatally acquired HIV: emerging behavioral and health needs for long-term survivors.
abstract: OBJECTIVE
  Because of widespread availability of highly active antiretroviral therapy in the developed world, a large proportion of children with perinatally acquired HIV have survived to adolescence and young adulthood. Although their survival is remarkable, many now experience the long-term effects of HIV infection and its treatment. Further, as these youths have entered adolescence, more is known about the impact of normative developmental transitions on health maintenance behaviors.
  
  
  RESULTS
  Although perinatally infected adolescents are healthier than they were a decade or more ago, they are significantly experienced with antiretroviral therapy, with increased virological resistance and other consequences of extended antiretroviral use. Three behavioral health challenges have been documented in the first cohort of long-term survivors: decreased medication adherence, sexual debut and accompanying pregnancy and transmission risk, and mental health problems. These issues are consistent with a developmental press for autonomy, mature sexual relationships and future planning, but must be carefully managed to preserve health.
  
  
  CONCLUSIONS
  Adolescents with perinatally acquired HIV require coordinated multidisciplinary support services - including adherence support, reproductive health counseling addressing both pregnancy planning and disease transmission, and mental health and educational/vocational planning - so that they can fully benefit from treatment advances.
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop D-27, Atlanta,GA 30333, USA. LKoenig@cdc.gov
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Koenig
authors.forename: Steven
authors.initials: S
authors.lastname: Nesheim
authors.forename: Susan
authors.initials: S
authors.lastname: Abramowitz
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology* / Q000635:transmission; D015497:HIV-1 / Q000187:drug effects; D015438:Health Behavior; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008297:Male; D055118:Medication Adherence; D020380:Needs Assessment; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012731:Sex Counseling; D012725:Sexual Behavior; D017741:Survivors / Q000523:psychology*
chemical_list: D019380:Anti-HIV Agents