Transitioning HIV-Positive Adolescents to Adult Care: Lessons Learned From Twelve Adolescent Medicine Clinics

Amanda E Tanner; Morgan M Philbin; Anna DuVal; Jonathan Ellen; Bill Kapogiannis; J Dennis Fortenberry; Adolescent Trials Network for HIV/AIDS Interventions

doi:10.1016/j.pedn.2016.04.002

Transitioning HIV-Positive Adolescents to Adult Care: Lessons Learned From Twelve Adolescent Medicine Clinics

J Pediatr Nurs. 2016 Sep-Oct;31(5):537-43. doi: 10.1016/j.pedn.2016.04.002. Epub 2016 Apr 28.

Authors

Amanda E Tanner¹, Morgan M Philbin², Anna DuVal³, Jonathan Ellen⁴, Bill Kapogiannis⁵, J Dennis Fortenberry⁶; Adolescent Trials Network for HIV/AIDS Interventions

Affiliations

¹ Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC, USA. Electronic address: aetanner@uncg.edu.
² HIV Center for Clinical and Behavioral Studies at Columbia University and New York State Psychiatric Institute, New York, NY, USA.
³ Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
⁴ Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD and All Children's Hospital, St. Petersburg, FL, USA.
⁵ Pediatric, Adolescent and Maternal AIDS Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
⁶ Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.

Abstract

To maximize positive health outcomes for youth with HIV as they transition from youth to adult care, clinical staff need strategies and protocols to help youth maintain clinic engagement and medication adherence. Accordingly, this paper describe transition processes across twelve clinics within the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) to provide lessons learned and inform the development of transition protocols to improve health outcomes as youth shift from adolescent to adult HIV care.

Design and methods: During a large multi-method Care Initiative program evaluation, three annual visits were completed at each site from 2010-2012 and conducted 174 semi-structured interviews with clinical and program staff (baseline n=64, year 1 n=56, year 2=54).

Results: The results underscore the value of adhering to recent American Academy of Pediatrics (AAP) transition recommendations, including: developing formal transition protocols, preparing youth for transition, facilitating youth's connection to the adult clinic, and identifying necessary strategies for transition evaluation.

Conclusions: Transitioning youth with HIV involves targeting individual-, provider-, and system-level factors. Acknowledging and addressing key barriers is essential for developing streamlined, comprehensive, and context-specific transition protocols.

Practice implications: Adolescent and adult clinic involvement in transition is essential to reduce service fragmentation, provide coordinated and continuous care, and support individual and community level health.

Keywords: Adolescents; HIV; Healthcare; Transition; Young adults.

Publication types

Multicenter Study

MeSH terms

Adolescent
Adolescent Behavior
Adult
Ambulatory Care Facilities / organization & administration
Anti-HIV Agents / therapeutic use*
Female
HIV Infections / diagnosis
HIV Infections / drug therapy*
Health Care Surveys
Humans
Learning
Male
Organizational Innovation*
Outcome Assessment, Health Care*
Patient Compliance / statistics & numerical data
Program Development
Program Evaluation
Risk Assessment
Transition to Adult Care / organization & administration*
United States
Young Adult

Substances

Anti-HIV Agents

Abstract

Publication types

MeSH terms

Substances

Grants and funding