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

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

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