Treatment issues for HIV-positive adolescents.

This second part of a series on HIV treatment in adolescents aged 13 to 21 highlights the clinical challenges posed by physical and psychosocial development. Special challenges involve helping adolescents adjust to their HIV status and take their medications correctly. A description is provided of the REACH study (Reaching for Excellence in Adolescent Care and Health), which involves 300 HIV-positive and 150 HIV-negative volunteers aged 12 to 19. The study looks at disease progression and manifestations, effects of puberty on treatment, interactions between HIV and other sexually transmitted diseases, and social and mental health. Major issues faced by HIV-positive adolescents are discussed, including receiving a diagnosis and coping with the disease. Guidelines are given for providing adolescent-centered healthcare. Tables illustrate transmission categories, testing methods for other sexually transmitted diseases, immunizations, and suggested adherence methods.