Experiences Of Adults Research Articles

Perceived discrimination, mental health help-seeking attitudes, and suicide ideation, planning, and attempts among black young adults

BackgroundDeveloping an understanding of the negative impact of discrimination is critical when examining the suicidality of Black young adults in the US. Suicide rates among Black young adults have increased at alarming rates. One of the reasons for this increase is the disparities related to access to mental health services, which has long-term health consequences. This study addresses a significant gap in the literature by examining associations between experiences of everyday discrimination, attitudes towards mental health help-seeking attitudes, on the outcomes suicide ideation, planning to die by suicide, and suicide attempts.MethodsThe data came from a national study of the experiences of Black young adults regarding mental, physical, and sexual health. Participants were recruited from across the Midwestern region of the United States through Qualtrics Panels, an online survey delivery service used to recruit study participants. The total sample for this study was N = 362, and the average age of the sample was 21 (SD: 1.96). We used a logistic regression analysis to examine the role of everyday discrimination, mental health support-seeking attitudes, and covariates on the outcomes: suicide ideation, planning to die by committing suicide, and suicide attempts.ResultsBlack young adults with positive mental health help-seeking attitudes were 34% less likely to attempt suicide (OR = 0.66; 95% CI: 0.46, 0.96) and 35% less likely to experience suicide ideation (OR = 0.65; 95% CI: 0.47, 0.89). However, those young adults who experienced discrimination daily were more likely to report having attempted suicide (OR = 1.70; 95% CI: 1.34, 2.15).ConclusionsOur findings offer valuable insights into the complex interplay between experiences of discrimination, attitudes toward seeking mental health support, and suicidal behaviors. However, our research also underscores how experiences of discrimination can significantly exacerbate feelings of isolation, hopelessness, and inadequacy, further contributing to suicidal behaviors in this population. By promoting positive mental health help-seeking behaviors, actively addressing discrimination, and applying an intersectional approach to suicide prevention efforts, we can take significant strides towards building a more supportive and inclusive society. This approach aims to empower individuals to seek help, reduce the risk of suicidal behaviors, and create a more welcoming environment for all members of our community.

Childhood Adversity and Incident Psychotic Experiences in Early Adulthood: Cognitive and Psychopathological Mediators.

Childhood adversity is often described as a potential cause of incident psychotic experiences, but the underlying mechanisms are not well understood. We aimed to examine the mediating role of cognitive and psychopathological factors in the relation between childhood adversity and incident psychotic experiences in early adulthood. We analyzed data from the Avon Longitudinal Study of Parents and Children, a large population-based cohort study. Childhood adversity was measured prospectively from birth to age 11 years, mediators (anxiety, depression, external locus of control [LoC], negative symptoms) were assessed at approximately 16 years of age, and incident psychotic experiences were assessed at ages 18 and 24 years. Mediation was examined via the counterfactual g-computation formula. In total, 7% of participants had incident suspected or definite psychotic experiences in early adulthood. Childhood adversity was related to more incident psychotic experiences (ORadjusted = 1.34, 95% CI = 1.21; 1.49), and this association was partially mediated via all mediators examined (proportion mediated: 19.9%). In separate analyses for each mediator, anxiety, depression, external LoC, and negative symptoms were all found to mediate the link between adversity and incident psychotic experiences. Accounting for potential confounders did not modify our results. Our study shows that cognitive biases as well as mood symptomatology may be on the causal pathway between early-life adversity and the development of psychotic experiences. Future studies should determine which mediating factors are most easily modifiable and most likely to reduce the risk of developing psychotic experiences.

The experiences of daily smartphone use among older adults in Brazil: A grounded theory analysis

BackgroundDigital inclusion of older people is an important agenda for the future and well-being of the older population, as it represents a form of social inclusion with significant gains for healthy aging. The present study aimed to understand the experiences of Brazilian older adults who use smartphones and the implications in their daily lives. MethodA qualitative study was developed using a constructivist grounded approach. Older people (≥60 years) with prior access to a smartphone were invited to participate in the study. Participation took place through semi-structured, audio-recorded interviews. Data collection and analysis occurred simultaneously using a constant comparative approach. Data management and analysis used the Atlas.ti® software. ResultsOverall, 37 older people participated, with an average age of 70.60 ± 6.95 years, predominantly female (n = 33), white (n = 25), married (n = 26) and retired (n = 27). The first sample group included 27 older people with family support and the second group included 10 older people without family support (who lived alone in their homes). A core category emerged from the data analysis—“Expanding the personal and social development of older adults through smartphone communication”—around which three main categories emerged: 1) The smartphone as “a window to the world”; 2) The problem of misinformation and fake news on virtual networks; 3) Technological paradoxes in the use of smartphones. ConclusionsThe digital transition associated with smartphone use brings unimaginable benefits to older adults who adopt positive habits to improve their well-being and expand their social connections, following efforts proposed by the Decade of Healthy Aging. However, older adults still face disparities and experience a significant digital divide, which represents a major challenge. Barriers to access are further aggravated in developing countries. We hope this study contributes to public health policies on digital inclusion and healthy aging.

‘At least you got to see people when you went out for a walk’: older adults’ lived, embodied experiences during COVID-19 times in the United Kingdom

ABSTRACT The COVID-19 pandemic presented myriad global challenges, placing unprecedented pressure on health services. Currently, there is limited qualitative research exploring the ‘felt’ impact of the pandemic on older adults’ health experiences and wider social life. Here, we report on the embodied experiences of older adults (65 and above), before, during and after the COVID-19 pandemic lockdowns in the UK, to chart the physical, social, and mental-health challenges. A figurational sociological lens was adopted to examine data from semi-structured interviews with 18 older adults, face-to-face or via telephone/video call. Notes from follow-up conversations were also recorded. Combined data were analysed thematically. Salient themes cohered around: physical activity engagement; health experiences; the role of family, friends, and community; and the role of modern technology. Our results highlight how older adults reported the felt benefits of increased PA during lockdowns, but also the negative impacts of treatment delays on experiences of hospital services. Participants also recounted how new social community connections were forged during lockdowns. Saliently, we identified a need to support older adults with modern technology so as to capture its potential to modernise, expand, and personalise healthcare within UK health services.

“My struggles are largely sensory processing:” The sensory world of autistic people

ABSTRACT This article delved into the sensory experiences of autistic adults, drawing on ethnographic fieldwork conducted in British Columbia, Canada. Thematic analysis of qualitative data revealed how unusual perceptual sensitivities impact the emotional well-being of autistic people, complicating their social interactions and relationships and contributing to social isolation. However, autistic individuals adopt diverse sensory and social coping strategies, and constantly adapt their previous sensory and social experiences to particular social and physical environments. This enables them to deal with their sensory challenges while interacting and socializing with others and engaging in social relationships. These ongoing adaptative processes also produce distinctive sociability patterns and perceptions among autistic people, reflecting both the stress associated with social interaction and the intense desire for it. Accordingly, this study highlighted the need for greater awareness of sensory phenomena and of social and physical environments to understand the daily and life experiences of autistics individuals.

Technology Use for Social Interaction Amongst Older Adults During the COVID-19 Pandemic: A Qualitative Study.

The COVID-19 pandemic had an impact on socialization across all age groups but older adults experienced additional challenges. The purpose of this study was to explore older adults' perceptions and experiences of using technology to support social interactions during the COVID-19 pandemic. We used a qualitative interpretive descriptive approach to understand community dwelling older adults' perceptions of their experiences. We analyzed data using an interpretive thematic analysis approach. Forty-one older adults (median age 74yrs) participated in in-depth interviews exploring experiences of using technology to support their social interaction during the pandemic. Participants discussed the transition towards virtual means of socialization during the pandemic, perceptions of using technology for social interaction, and challenges to adapting to virtual connection. We discuss our findings and the implications for how we introduce technology to older adults.

New noninvasive modalities in long-term pediatric ventilation: a scoping review.

Long-term noninvasive ventilation modalities for the pediatric population have undergone a continuous evolution. Hybrid noninvasive ventilation modalities have been recently introduced in clinical practice. Combining the advantages of conventional ventilation, hybrid modes use algorithms that automatically adjust the ventilator's settings to achieve a predefined ventilation target. Most of the recommendations on the use and settings of hybrid noninvasive ventilation modalities in children are derived from adult experience. Therefore, there is a lack of evidence on its implementation in pediatric chronic respiratory diseases. This scoping review aims to map the existing information regarding the use of hybrid ventilation modalities in the pediatric population and identify knowledge or research gaps. We performed a literature search using MEDLINE and Pubmed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We included 13 studies (ten studies on average volume-assured pressure-support ventilation; two studies on intelligent volume-assured pressure-support ventilation; and one study on adaptive servoventilation). The use of new noninvasive ventilation modes in the pediatric population has been applied for the treatment of neuromuscular and hypoventilation syndromes as an alternative therapeutic option in the case of the failure of conventional noninvasive ventilation. Their widespread use has been hampered by the limited evidence available. Longitudinal studies on a larger number of patients are needed to confirm their effectiveness and evaluate their long-term clinical and functional outcomes.

Tuned In! An affirmative mindfulness intervention for sexual and gender diverse young people

Sexual and gender diverse youth and young adults (SGDY) experience significant mental health disparities compared to non-SGDY, which is exacerbated by ongoing anti-LGBTQIA + political attacks across the U.S. SGDY lack access to culturally responsive mental health supports and are overlooked in clinical practice/research. Mindfulness is a transformative practice that fosters well-being and provides tools to address the psychological impact of discriminatory experiences. This study investigated feasibility, acceptability, and outcomes of a mindfulness-based intervention (MBI), Tuned In!, co-developed with SGDY to improve mental health and navigate and challenge the current anti-LGBTQIA + sociopolitical context. Participants (n = 56), 16 to 29 yrs., were recruited and participated online. Surveys were administered pre, post-intervention, and at 6-month follow-up. Hierarchical Linear Modeling and Reflexive Thematic Analysis were used to analyze data. Rates of engagement and retention were high. High levels of satisfaction and acceptability, a significant decrease in depression, anxiety, and psychological distress, and a significant increase in sexual self-efficacy, mindfulness, and self-compassion were found, with gains maintained at 6-month follow-up. Qualitative analysis uncovered the following themes: Development of Crucial Coping Skills and Strategies, A Sense of Community Among SGDY, Learning from Peers Through Dialogue. Study results suggest that Tuned In! is a promising intervention to improve SGDY mental health.

Virtual reality-based reminiscence therapy for older adults to improve psychological well-being and cognition: A systematic review.

Virtual reality-reminiscence therapy (VR-RT) has increasingly been applied to older adults to improve psychological well-being and cognition. This review aims to identify (1) the design characteristics of conducting a VR-RT and (2) the effects of VR-RT on the user experience, cognitive outcomes and psychological well-being. Systematic review. Eligible studies were sourced across nine electronic databases, trial registries, grey literature and hand-searching of the reference list. A narrative synthesis was conducted. Twenty-two studies were included, and most were appraised as high quality. Most of the VR-RTs were highly immersive and personalised, with participants having the autonomy of control. VR-RT has the potential to improve anxiety and depression, and cognitive outcomes for older adults. Overall, VR-RT was reported to be an enjoyable experience for older adults. VR-RT is a promising innovation that can improve older adults' psychological well-being and cognition without significant side effects, including cybersickness and with the potential for scalability across various settings. More randomised controlled studies are needed to evaluate the effectiveness of VR-RT and its features and treatment dosage. These studies could also examine the effectiveness of VR-RT as an intervention to promote independence in activities of daily living and physical rehabilitation. VR-RT is a promising intervention for older adults in community settings to enhance psychological well-being and cognition. VR's versatility enables personalised experiences within dynamic virtual environments, possibly enhancing engagement and therapeutic outcomes. This systematic review did not directly involve patient or public contribution to the manuscript.

The employment expectations of adolescents: Examining the role of social origin, parental support, and personality traits

Early life course conditions and the social origin of families frequently influence the inequalities people experience in adulthood. The transition from education to work is a challenging period during which adolescents make their first employment-related choices and establish the course of their careers. Future expectations guide adolescents’ employment-related choices and are assumed to influence future employment outcomes. Therefore, this paper investigates whether family (dis)advantages affect adolescents’ employment expectations. We assess various underlying mechanisms that may influence the relationship between social origin and adolescents’ employment expectations by using cross-sectional data from the German Socio-Economic Panel (SOEP: 2006–2018), specifically a youth questionnaire administered at age 17. Three key findings emerge. First, family disadvantages, particularly an insecure parental labor market participation, influence the employment expectations of adolescents negatively. Second, supportive parenting does not mediate the relationship between social origin and the employment expectations of adolescents; instead, it functions as an additional positive factor. Third, supportive parenting creates more optimistic employment expectations because it fosters specific “beneficial” personality traits, such as extraversion, conscientiousness, openness, agreeableness, and internal control beliefs.

The Experience of Adolescents and Young Adults in Their Cancer Journeys in Japan: I Try to Move Forward With Feeling That I Would Be Okay With "My Cancer".

Purpose: A cancer diagnosis can greatly affect adolescents and young adults (AYAs), especially those in their late teens and early twenties, who might have their special needs. This study aimed to understand the experiences of the AYAs who were diagnosed between 15 and 24 years of age in Japan, thinking about the care guide supporting them, from the time of their cancer diagnosis through the rest of their lives. Methods: Data were collected using semi-structured interviews, which were audio recorded and transcribed verbatim. Qualitative analysis of the transcripts was used to categorize these into themes for comprehensive interpretation. Results: Twenty AYAs participated; they were diagnosed between the ages 15 and 23 and were 19-29 years old at the time of the interview. In total, 14 core categories were identified, consisting of three themes (1) There is a feeling of distance between the cancer and me, (2) I face "my cancer" in my way, and (3) I feel that I would be okay with "my cancer." Conclusions: AYAs had their way of dealing with cancer while experiencing a distant feeling between themselves and the presence of the disease during their cancer journey. Although the process was not simple, they tried to live their lives in their own way, believing that they would be okay. Nurses must respect and understand that AYAs have a process of facing their own cancer with time and watch over AYAs' experiences to appropriately support them to successfully proceed further.

The scope of supportive housing for adults with fetal alcohol spectrum disorder: a rapid review

Objectives Many individuals with fetal alcohol spectrum disorder (FASD) face challenges accessing suitable housing support, which increases the likelihood of adverse outcomes and daily living difficulties that can persist throughout adulthood. Our rapid review assesses the current scope of literature that reports on existing housing programs and supports for adults with FASD. Methods PubMed, Social Work, CINAHL, PsychINFO, Sociological s, and Social Services s were searched to identify published peer-reviewed articles. Grey literature was identified through a Google search strategy and a manual search through FASD-specific organizational websites in the US, Canada, Australia, and the UK. A total of 866 citations were screened in Covidence, nine of which met the inclusion criteria for analysis: five peer-reviewed articles and four grey literature sources. Results Adults with FASD face significant barriers when accessing supportive housing services. The findings underscore the need for FASD-informed approaches to foster interdependence among adults, their families, and support networks. Conclusions Supportive housing programs for adults with FASD are sparse, and existing programs often fall short of addressing the holistic needs of these individuals. Future research prioritizing the lived and living experiences of adults accessing support, focusing on the effectiveness of specific support strategies, is warranted.

“Utterly Overwhelming”—A Mixed-Methods Exploration of Sensory Processing Differences and Mental Health Experiences in Middle-Aged and Older Autistic Adults

“Utterly Overwhelming”—A Mixed-Methods Exploration of Sensory Processing Differences and Mental Health Experiences in Middle-Aged and Older Autistic Adults

Reconceptualising the role of direct support staff for adults with intellectual disabilities by introducing the holistic support model

ABSTRACT Background: This study aims to introduce direct support staff (DSS) working with adults with intellectual disabilities to the Holistic Support Model (HSM) and assess its influence on their perceptions of their professional role. The HSM, grounded in humanistic principles, guides the support process, prioritising autonomy and meaningful living. Method: Using participatory action research, this study used survey data, qualitative analysis of group meetings, and interviews, to assess changes in DSSs' role perceptions after undergoing in-service training on the HSM. Results: DSS exhibited a shift towards a humanistic perspective, gaining clarity on their roles, which reduced frustration. Doubts persist among DSS regarding the applicability of the HSM to all adults with intellectual disabilities. Conclusions: The studies underscore the positive impact of the HSM on DSS, highlighting its potential to enhance DSS practice. It recommends researching the experiences of adults with intellectual disabilities with the HSM.

Immigrant Older Adults' Experiences of Aging in Place and Their Neighborhoods: A Qualitative Systematic Review.

Engaging in one's neighborhood fosters independence, promotes social connectedness, improves quality of life, and increases life expectancy in older adults. There is a lack of evidence synthesis on immigrant older adults' neighborhood perceptions and experiences, essential for addressing neighborhood-level influences on aging in place. This study systematically synthesizes qualitative evidence on immigrant older adults' perceptions and experiences of their neighborhoods. A comprehensive search was conducted from inception to 5 April 2023, in multiple databases. This review considered studies including immigrant older adults aged ≥60 years, included studies from any country where the neighborhood was the focus, and only considered qualitative data while excluding review studies, theoretical publications, and protocols. Eligible studies were appraised using the JBI critical appraisal checklist for qualitative research. The Joanna Briggs Institute meta-aggregation approach was used to synthesize findings, and the ConQual approach established confidence in the synthesis. A total of 30 studies were included. Most studies were conducted in North America and explored phenomena such as aging in place, social capital, social cohesion, sense of community, and life satisfaction. Key contextual factors were walkable safe access to social spaces, accessible transportation to amenities, social cohesion with neighbors, and pre-migration neighborhood experiences. Immigrant older adults have varied experiences related to their sense of belonging and social cohesion. Factors such as racial discrimination, feeling unsafe, and social isolation contributed to negative perceptions. This review highlights the need for inclusive neighborhoods that align with the needs and values of immigrant older adults aging in place.

Understanding banking experiences of autistic adults: an inquiry into inclusive banking

Purpose Navigating the banking world may be overwhelming and intimidating for autistic people due to the generally poor accessibility of banks. Banks around the world are starting to improve the accessibility of their services and products to meet the needs of autistic customers better. However, no empirical research has explored autistic adults’ banking experiences and needs. This study aims to determine what banks can do to make banking more inclusive and accessible for autistic people through understanding the banking experiences of autistic adults living in Australia and identifying the factors that shape these experiences. Design/methodology/approach In total, 57 autistic adults aged 18–67 years (Mage = 33.00, SDage = 11.03) and 29 caregivers of autistic adults aged 32–70 years (Mage = 52.24, SDage = 7.88) completed an online survey about the banking experiences of the autistic adults. In addition, 14 of the 57 autistic adults were interviewed. Findings Almost all autistic participants had a bank account, and online banking was the preferred way of banking for most autistic adults. The factor most often raised by participants that influenced the banking experiences of autistic adults was supportive and helpful bank staff. Other identified factors included autistic adults’ lack of financial and banking knowledge and banks’ poor understanding of autism. The majority of autistic adults felt that banks could become more autism-friendly and provided suggestions. Practical implications Given that most autistic adults are likely to access financial products and services, banks must become more autism-friendly to cater to the diverse needs of autistic customers. Recommendations for how financial institutions can become more inclusive were provided. Originality/value To the best of the authors’ knowledge, this is the first detailed examination of the banking experiences of autistic adults. Practical implications of the research were also provided.

Exposure of women undergoing in-vitro fertilization to per-and polyfluoroalkyl substances: Evidence on negative effects on fertilization and high-quality embryos

In April 2023, the World Health Organization (WHO) reported that 17.5% of the global adult population experience infertility. What may be the contribution of per-and polyfluoroalkyl (PFAS) to this global public health problem?This study explored the associations between in vitro fertilization (IVF) outcomes and plasma concentrations of individual PFAS and PFAS mixtures in women undergoing in vitro fertilization and embryo transfer (IVF-ET) and how these exposures might affect IVF outcomes. We analyzed 8 PFASs in plasma samples from women (N = 259) who underwent IVF treatment. In multivariable generalized linear mixed models, there were statistically significant associations of higher plasma concentrations of PFNA with reduced numbers of total retrieved oocytes [12.486 (95%CI: 0.446,25.418), p trend = 0.017], 2 PN zygotes [6.467(95%CI: 2.034,14.968), p trend = 0.007], and cleavage embryos [6.039(95%CI: 2.162,14.240), p trend = 0.008]. Similarly, there was a continuous decline in the numbers of retrieved 2 PN zygotes and cleavage embryos with increasing concentration of PFOS [6.467(95%CI: 2.034,14.968), p trend = 0.009 and 6.039(95%CI: 2.162,14.240), p trend = 0.031,respectively] and a negative association between PFHxS concentrations and clinical pregnancy during the initial cycles of frozen ET [0.525(95%CI:0.410,0.640), p trend = 0.021]. To investigate the joint effect of PFAS mixtures, a confounder-adjusted BKMR model analysis showed inverse relationship between PFAS mixtures and the number of high-quality embryos, 2 PN zygotes and cleavage embryos, to which the greatest contributors to the mixture effect are PFDeA and PFBS, respectively. It demonstrated that PFAS exposure might exert negative effects on oocyte yield, fertilization and high-quality embryo in women undergoing IVF. These findings suggest that exposure to PFAS may increase the risk of female infertility and further studies are needed to uncover the potential mechanisms underlying the reproductive effects associated with PFAS.

Adolescent offenders' experiences of father involvement in a South African context

AbstractObjectiveThe study's aim was to explore and describe adolescent offenders' experiences of their fathers' involvement before and during their own incarceration in a South African context.BackgroundResearch on father involvement is focused predominantly on adult offenders' experiences of father involvement without emphasis on adolescents' experiences regarding father involvement, including in a South African context.MethodsA qualitative explorative‐descriptive research design was employed. A nonprobability, purposive sampling technique was used, and the sample size was determined through data saturation. The sample included nine male adolescents between the ages of 17 and 19 years from a correctional center in Pretoria, South Africa. Semistructured individual interviews and drawings made by participants were used as the data collection methods and data were analyzed thematically.ResultsTwo main themes with subthemes were identified: Experiences of father absence before and/or during incarceration and desires for and suggestions to improve father involvement.ConclusionThe findings are primarily indicative of the general lack of father involvement and fatherly support experienced by participants.ImplicationsThe findings highlight the need for adolescent offenders to have access to counseling or therapy and intervention programs suitable for juvenile correctional centers focusing specifically on providing young, incarcerated, male adolescents with paternal role models that can help foster a sense of ethical and moral guidance and provision of different forms of support. Father intervention programs including men's talks, motivational speaking, and psychoeducational programs to advise fathers on how to be more involved in their children's lives are recommended.

“Living with a question mark”: psychosocial experience of Portuguese young adults at risk for hereditary amyloid transthyretin amyloidosis with polyneuropathy

This study is the first to explore the psychosocial experience of young Portuguese adults at genetic risk for hereditary amyloid transthyretin amyloidosis with polyneuropathy (hATTR-PN). The work focuses on the developmental peculiarities of their experience with the disease. Sixteen semi-structured interviews were conducted with young adults coming for pre-symptomatic testing (PST) at a single genetics outpatient center in Portugal. The data were analyzed qualitatively. The main findings suggest that four themes mark the psychosocial experience of the young adults interviewed. The first refers to the development of psychological representations, namely beliefs, mental representations, and social perceptions about hATTR-PN. The second regards the experienced and anticipated psychosocial impacts, namely, suffering, anxiety, and relief related to the disease. The third is related to using strategies such as performing PST, strategies focused on emotional regulation and the meaning of hATTR-PN, and social strategies to deal with these impacts over time. Finally, the fourth aspect concerns the perceived and expected support for the participants’ needs provided by social contexts, that is, family and genetic counseling. In a period of life also marked by qualitatively different characteristics and developmental tasks from other life cycle stages (e.g., identity explorations, instability, and independent decision-making), experience with the disease can add psychosocial challenges to young adults at risk for hATTR-PN. Genetic counseling practices and health policies can be optimized to respond to the psychosocial needs of young adults. Future research should deepen the understanding of the psychosocial experience of individuals and families with late-onset hATTR-PN to improve the clinical response in this population.

Study APV20002: Safety and Efficacy Results Through Week 684 for Pediatric Participants Living with HIV-1 Treated with Ritonavir-Boosted Fosamprenavir Oral Solution-Based Antiretroviral Therapy.

APV20002 was a multicenter, international, open-label study that began in 2003 investigating the pharmacokinetics, efficacy, and safety of ritonavir-boosted fosamprenavir (FPV/r) oral solution (OS) in combination with nucleoside reverse transcriptase inhibitor-based antiretroviral therapy (ART) in participants living with HIV-1 aged 4 weeks to <2 years with a primary endpoint at Week 48 (48W). Participants in APV20002 could continue in the study post-48W until FPV OS was locally available in their countries. Children were required to discontinue after reaching >39 kg or if FPV OS had no clinical benefit. Fifty-nine participants were enrolled; 5/59 received a single FPV OS visit for pharmacokinetic determinations. Most (38/54; 70%) were antiretroviral experienced; 39/59 participants had >48 weeks on treatment, 4/39 of whom discontinued after 48 weeks due to an adverse event (AE). At 48W, 88% of participants had HIV-1 RNA <400 copies/mL by Observed analysis; the proportion with HIV-1 RNA <400 copies/mL remained high (84%-100%) through Week 684. The median CD4+ cell count was 1,235 cells/mm3 [n = 51] at baseline, 1,690 cells/mm3 (n = 41) at Week 48, and 1,280 cells/mm3 (n = 21) at Week 180. From baseline to Week 684, 54/59 (92%) participants had ≥1 treatment-emergent AE regardless of causality; 42/59 (71%) had a treatment-emergent grade 2-4 AE, predominantly maximum toxicity: grade 2; 21/59 (36%) and 21/59 (36%) had severe or grade 3/4 AEs. From baseline to Week 684, 14/54 (26%) participants met virologic failure (VF) criteria, 9/14 before 48W. HIV from 1/9 VFs through 48W developed treatment-emergent reduced susceptibility to FPV and 1/9 to lamivudine/emtricitabine. Post-48W, 4/5 participants with VF had phenotype results; all were still susceptible to all study drugs at VF. In conclusion, FPV OS-based ART was efficacious and generally well tolerated in this long-running pediatric study through 684 weeks of treatment, with a safety profile consistent with experience in adults and older children.