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

TitleTransitioning HIV-Positive Adolescents to Adult Care: Lessons Learned From Twelve Adolescent Medicine Clinics.
Publication TypePublication
Year of Publication2016
AuthorsTanner AE, Philbin MM, Duval A, Ellen J, Kapogiannis B, J Fortenberry D
Corporate AuthorsAdolescent Trials Network for HIV/AIDS Interventions
JournalJ Pediatr Nurs
Volume31
Issue5
Pagination537-43
Date Published2016 Sep-Oct
ISSN1532-8449
KeywordsAdolescent, Adolescent Behavior, Adult, Ambulatory Care Facilities, Anti-HIV Agents, Female, Health Care Surveys, HIV Infections, Humans, Learning, Male, Organizational Innovation, Outcome Assessment (Health Care), Patient Compliance, Program Development, Program Evaluation, Risk Assessment, Transition to Adult Care, United States, Young Adult
Abstract

<p><b>UNLABELLED: </b>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.</p><p><b>DESIGN AND METHODS: </b>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).</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p><p><b>PRACTICE IMPLICATIONS: </b>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.</p>

DOI10.1016/j.pedn.2016.04.002
Alternate JournalJ Pediatr Nurs
PubMed ID27133767
PubMed Central IDPMC5026881
Grant ListU01 HD040533 / HD / NICHD NIH HHS / United States
U01 HD040474 / HD / NICHD NIH HHS / United States
L60 MD009069 / MD / NIMHD NIH HHS / United States
P30 MH043520 / MH / NIMH NIH HHS / United States
T32 MH019139 / MH / NIMH NIH HHS / United States
K01 DA039804 / DA / NIDA NIH HHS / United States