Transitioning HIV-Infected Youth Into Adult Health Care

Abstract

With advances in antiretroviral therapy, most HIV-infected children survive into adulthood. Optimal health care for these youth includes a formal plan for the transition of care from primary and/or subspecialty pediatric/adolescent/family medicine health care providers (medical home) to adult health care provider(s). Successful transition involves the early engagement and participation of the youth and his or her family with the pediatric medical home and adult health care teams in developing a formal plan. Referring providers should have a written policy for the transfer of HIV-infected youth to adult care, which will guide in the development of an individualized plan for each youth. The plan should be introduced to the youth in early adolescence and modified as the youth approaches transition. Assessment of developmental milestones is important to define the readiness of the youth in assuming responsibility for his or her own care before initiating the transfer. Communication among all providers is essential and should include both personal contact and a written medical summary. Progress toward the transition should be tracked and, once completed, should be documented and assessed. Pediatrics

The Happy Teen programme: a holistic outpatient clinic‐based approach to prepare HIV‐infected youth for the transition from paediatric to adult medical care services in Thailand

“…During the HT1 programme some youth reported communication problems with their caretakers regarding their HIV care. Thus, we felt it was important to engage caretakers in the HT2 programme to help them understand factors important in the transition from paediatric to adult HIV care services and to provide an opportunity to improve communication in the family [3,6,23]. We found that youth whose parents had died had lower knowledge scores at 18 months compared to those whose parents were alive.…”

Rates and Correlates of Antiretroviral Therapy Use and Virologic Suppression Among Perinatally and Behaviorally HIV-Infected Youth Linked to Care in the United States

“…20,21 One important barrier to linkage and engagement in care is the dearth of HIV-specialty care specifically geared toward adolescent developmental needs and the lack of seamless transition procedures to adult-based health care. 22 YLHIV must navigate traditional adolescent development issues with the added burden of living with a highly stigmatized illness while not yet having fully developed the internal and social resources to deal with these complex and often competing demands.…”

Systematic Review of the Impact of Transition Interventions for Adolescents With Chronic Illness on Transfer From Pediatric to Adult Healthcare

“…Over the past decade, the transition from pediatric to adult health care of adolescents and young adults (AYA) with a variety of chronic health conditions has garnered increasing attention (Baldassano et al, 2002; COMMITTEE ON PEDIATRIC AIDS, 2013; Crowley, Wolfe, Lock, & McKee, 2011; DeBaun & Telfair, 2012; Freyer, 2010; Jurasek, Ray, & Quigley, 2010; Peters & Laffel, 2011; Prior, McManus, White, & Davidson, 2014; J. Reiss & Gibson, 2002; Sable et al, 2011; Tuchman, Schwartz, Sawicki, & Britto, 2010).…”