The Gap in Integrated Pediatric Care: A Systematic Review of Family-Based Weight Management for Children Living with HIV.

Abstract

<h4>Background</h4>As children living with HIV (CWH) achieve longer life expectancy, they face an emerging 'double burden' of infectious and non-communicable diseases, specifically pediatric overweight and obesity (OW/OB). This risk is exacerbated by weight-inducing Integrase Strand Transfer Inhibitors (INSTIs). We systematically reviewed family-based pediatric weight management interventions for CWH aged 6 to 12 globally.<h4>Methods</h4>Following PRISMA guidelines (PROSPERO: CRD42024554376), we searched Medline, Embase, and Cochrane (2007-2024) for clinic-linked behavioral interventions reporting body composition or behavioral outcomes.<h4>Results</h4>From 1026 records and 7 full-text reviews, no studies met the inclusion criteria. Excluded studies lacked clinical integration or targeted adult populations.<h4>Conclusion</h4>This 'null' finding represents a critical evidence gap and clinic concern: CWH receive weight-inducing medications without evidence-based behavioral support. Future research must prioritize integrating care models using implementation science frameworks (RE-AIM/CFIR) to bridge the gap between primary HIV care and obesity management in resource-constrained settings.