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AIDS Patient Care STDS. 2017 Oct;31(10):421-427. doi: 10.1089/apc.2017.0131.

Adolescent and Adult HIV Providers' Definitions of HIV-Infected Youths' Successful Transition to Adult Care in the United States.

Author information

1
1 Department of Sociomedical Sciences, Columbia University Mailman School of Public Health , New York, New York.
2
2 Department of Public Health Education, University of North Carolina Greensboro , Greensboro, North Carolina.
3
3 Department of Applied Health, Southern Illinois University Edwardsville , Edwardsville, Illinois.
4
4 Preterm Birth Initiative, University of California San Francisco , San Francisco, California.
5
5 Hubert Department of Global Health, Emory University Rollins School of Public Health , Atlanta, Georgia .
6
6 Maternal and Pediatric Infectious Disease Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health , Bethesda, Maryland.
7
7 Department of Pediatrics, Indiana University School of Medicine , Indianapolis, Indiana.

Abstract

It is important for both individual- and population-level health that HIV-infected individuals progress through the Care Continuum. However, HIV-infected youth frequently disengage from care during transition from pediatric/adolescent to adult care; only 50% remain in adult care after 1 year. Understanding how providers define and approach a successful healthcare transition can improve the delivery of HIV-related services during critical years of HIV treatment. We conducted 58 staff interviews across 14 Adolescent Trials Network clinics (n = 30) and 20 adult clinics (n = 28). We used the constant comparative method to examine how providers defined and approached youths' successful transition. Providers identified four components critical to successful transition: (1) clinical outcomes (e.g., medication adherence and viral suppression); (2) youth knowing how to complete treatment-related activities (e.g., refilling prescriptions and making appointments); (3) youth taking responsibility for treatment-related activities and their overall health (e.g., "when they stop reaching out to the adolescent [clinic] to solve all their problems."); and (4) youth feeling a connection and trust toward the adult clinic (e.g., "they feel safe here"), with some providers even prioritizing connectedness over clinical outcomes (e.g., "Even if they're not taking meds but are connected [to care], …that's a success."). The identification of key components of successful transition can guide focused interventions and resources to improve youth maintenance in the HIV Care Continuum as they transition to adult care. Identifying what facilitates successful transitions, and the gaps that interventions can target, will help to ensure HIV-infected youth remain healthy across their lifespan.

KEYWORDS:

HIV/AIDS; adolescent health; barriers to care; care transition; qualitative; transition success

PMID:
28981334
PMCID:
PMC5650713
DOI:
10.1089/apc.2017.0131
[Indexed for MEDLINE]
Free PMC Article

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