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

Area of Science:

• Pediatric HIV care
• Obesity management
• Implementation science

Background:

• Children with HIV (CWH) face a "double burden" of infectious and non-communicable diseases, including overweight and obesity (OW/OB).
• Weight-inducing Integrase Strand Transfer Inhibitors (INSTIs) used in HIV treatment exacerbate OW/OB risk in CWH.
• Pediatric OW/OB is a growing concern for CWH with increased life expectancy.

Purpose of the Study:

• To systematically review family-based pediatric weight management interventions for CWH aged 6 to 12 globally.
• To identify existing evidence-based behavioral support for CWH experiencing OW/OB.
• To address the emerging challenge of pediatric overweight and obesity in children living with HIV.

Main Methods:

• Systematic literature review following PRISMA guidelines.
• Searched Medline, Embase, and Cochrane databases from 2007 to 2024.
• Included clinic-linked behavioral interventions reporting body composition or behavioral outcomes.

Main Results:

• No studies met the inclusion criteria for family-based pediatric weight management interventions for CWH.
• 1026 records and 7 full-text reviews were screened.
• Excluded studies lacked clinical integration or targeted adult populations.

Conclusions:

• A critical evidence gap exists regarding weight management support for CWH on weight-inducing medications.
• There is an urgent need for evidence-based behavioral interventions for pediatric overweight and obesity in CWH.
• Future research should focus on integrating HIV primary care and obesity management using implementation science frameworks, especially in resource-constrained settings.