Retention in care after transition to adult care for adolescents and young adults with HIV: A systematic review and meta-analysis

Objective: To evaluate the retention rates of adolescents and young adults (aged 10-25 years) living with HIV during the transition to adult HIV care.

Methods: The study involved 15 cohort studies conducted since 2015, focusing on adolescents and young adults aged 10-25 years living with HIV who transitioned to adult care. The primary outcome measured was the retention rate in care after transition. Data screening and extraction were performed using Covidence software, and the quality of included studies was assessed using the Joanna Briggs Institute tool.

Results: The pooled 1-year retention rate was 81% (95% CI: 78%, 91%), while the 2-year retention rate was 69% (95% CI: 53%, 83%). Significant heterogeneity was observed between studies (I² = 96.73%). Subgroup analyses revealed geographical differences, with Asia exhibiting the highest retention rates. Retrospective study designs yielded better retention outcomes.

Conclusion: The findings underscore the challenges and variability in retention rates for adolescents transitioning to adult HIV care. There is a critical need for targeted interventions and improved follow-up strategies to enhance retention and meet global HIV care targets.