The psychosocial issues of children with perinatally acquired HIV disease becoming adolescents: a growing challenge for providers.

Today, providers caring for children who have perinatally acquired HIV disease treat them differently than they did less than a decade ago. As our knowledge of HIV and its treatment have grown, so have we and so have our children. We are seeing the first wave of adolescents with perinatally acquired HIV disease. This increased longevity has given new meaning to past challenges such as treatment regimens, medication adherence, disclosure, and permanency planning previously faced by providers, children, and their families. New challenges, such as adolescent treatment decisions, relationships, intimacy, college, and careers have been added to the list. As a prediatric nurse practitioner having "grown up" with perinatally acquired HIV disease in the last decade, I reflect on past challenges and offer a perspective on those that lie ahead. A multidisciplinary, family-centered support group intervention that was developed at our AIDS Center Program to assist families, older children, adolescents, and providers in facing these challenges is described.