{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T15:04:04Z","timestamp":1784300644412,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>HIV remains a major global burden, with 2.4 million children and adolescents affected, 84% living in sub\u2010Saharan Africa. As adolescents age, transitioning from paediatric to adult HIV care represents a critical period that may significantly affect antiretroviral therapy (ART) adherence, retention in care and virological suppression. A systematic evaluation of evidence from sub\u2010Saharan Africa is essential to quantify the effects of healthcare transition on virological outcomes, especially viral suppression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We systematically searched three electronic databases: PubMed, Scopus and Embase for studies published between January 1, 2015, and March 5, 2025, using keywords HIV, adolescents, transition to adult care and virological outcome. A narrative synthesis was used to summarize the findings, and meta\u2010analyses were conducted using random\u2010effects models to estimate pooled proportions with corresponding 95% confidence intervals. Heterogeneity between studies was quantified using the\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistic, and potential sources of variability were explored through subgroup analyses based on study characteristics. The risk of bias for the included studies was assessed according to the study design using the Newcastle\u2013Ottawa Scale. This review was registered with PROSPERO (CRD420251005361).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The systematic search identified 1324 articles, of which 8 met the predefined inclusion criteria and were included in the final analysis. These studies consisted of 13\u2009819 adolescents and young adults aged between 10 and 26\u2009years. The pooled proportions of viral suppression were 75% (95% confidence interval [CI]: 68%\u201381%,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      : 89.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) before transition and 67% (95% CI: 44%\u201384%,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      : 95.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) after transition.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is a decline in viral suppression following the transition from paediatric to adult HIV care in sub\u2010Saharan Africa, indicating the need for targeted strategies to sustain suppression post\u2010transition. Future large\u2010scale longitudinal studies should use standardized transition age definitions, consistent follow\u2010up durations and uniform virological suppression thresholds to ensure robust and comparable evidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70221","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T08:54:12Z","timestamp":1773392052000},"page":"872-885","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of transition from paediatric to adult\n                    <scp>HIV<\/scp>\n                    care on virological outcomes in sub\u2010Saharan Africa: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1006-4319","authenticated-orcid":false,"given":"Petra E.","family":"Joseph","sequence":"first","affiliation":[{"name":"Department of Community Health School of Public Health, Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabel M.","family":"Itaeli","sequence":"additional","affiliation":[{"name":"Department of Community Health School of Public Health, Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Amour","sequence":"additional","affiliation":[{"name":"Department of Community Health School of Public Health, Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4867-7200","authenticated-orcid":false,"given":"George Msema","family":"Bwire","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Microbiology School of Pharmacy, Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"WHO.Epidemiological Fact Sheet: HIV statistics globally and by WHO region 2023.2023. HIV Data Stat [Internet].https:\/\/cdn.who.int\/media\/docs\/default\u2010source\/hq\u2010hiv\u2010hepatitis\u2010and\u2010stis\u2010library\/j0294\u2010who\u2010hiv\u2010epi\u2010factsheet\u2010v7.pdf?sfvrsn=5cbb3393_7"},{"key":"e_1_2_10_3_1","unstructured":"UNICEF.Global and Regional Trends. Internet [Internet].2024.https:\/\/data.unicef.org\/topic\/hivaids\/adolescents-young-people\/"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461\u2010019\u201002621\u20106"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/23259582221143673"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/17582652.2017.1297524"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/children10050798"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20104642(18)30005\u20101"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.20.4.21528"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192214911"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0198802"},{"issue":"3","key":"e_1_2_10_12_1","first-page":"71","article-title":"Growing up with perinatal HIV: changes in clinical outcomes before and after transfer to adult care in the UK","volume":"20","author":"Judd A","year":"2017","journal-title":"J Int AIDS Soc"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed9090198"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-024-04534-5"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.20.4.21506"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/23744235.2016.1143964"},{"issue":"1","key":"e_1_2_10_17_1","first-page":"139","article-title":"JDF. 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Policy brief consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection what's new.2015."},{"key":"e_1_2_10_32_1","unstructured":"World Health Organization policy brief. The role of HIV viral suppression in improving individual health and reducing transmission: policy brief. Geneva: World Health Organization; 2023. WHO. 2023. 16."}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70221","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.70221","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70221","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T14:12:12Z","timestamp":1784297532000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.70221"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,13]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/hiv.70221"],"URL":"https:\/\/doi.org\/10.1111\/hiv.70221","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,13]]},"assertion":[{"value":"2025-08-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}