Adolescents living with perinatally acquired HIV in South Africa face significant barriers to successful transition from pediatric to adult care. We performed in-depth qualitative interviews with 41 adolescents living with HIV and 18 of their caregivers to investigate modifiable factors to improve engagement in care prior to transition to adult care. Based on dyadic, inductive content analysis, findings suggest that HIV status disclosure, social support, and mental health are targets for improvement in engagement in care. Early disclosure and a sense of belonging facilitated engagement in care, while barriers included delayed or inadequate disclosure, denial, and lack of disclosure to others. Adherence support improved by having a biological mother as a direct supervisor. Barriers to care included changing caregivers, abandonment, undiagnosed mental health problems and learning difficulties. Despite these factors, the majority of adolescents showed resilience and remained engaged in care despite difficult circumstances.

在南非，感染围产期艾滋病毒的青少年在成功从儿科护理过渡到成人护理方面面临重大障碍。我们对 41 名感染 HIV 的青少年和他们的 18 名照料者进行了深入的定性访谈，以调查可改变的因素，以在过渡到成人照料之前提高照料参与度。基于二元归纳内容分析，研究结果表明，HIV 状态披露、社会支持和心理健康是改善参与护理的目标。早期披露和归属感有助于参与护理，而障碍包括延迟或不充分披露、否认和缺乏对他人的披露。通过将亲生母亲作为直接主管来改善依从性支持。护理障碍包括更换护理人员、遗弃、未确诊的心理健康问题和学习困难。尽管存在这些因素，但大多数青少年表现出适应力，并在困难的情况下仍然参与护理。