Adolescent to Adult HIV Health Care Transition From the Perspective of Adult Providers in the United States.

TitleAdolescent to Adult HIV Health Care Transition From the Perspective of Adult Providers in the United States.
Publication TypePublication
Year of Publication2017
AuthorsTanner AE, Philbin MM, Ma A, Chambers BD, Nichols S, Lee S, J Fortenberry D
Corporate AuthorsAdolescent Trials Network for HIV/AIDS Interventions
JournalJ Adolesc Health
Volume61
Issue4
Pagination434-439
Date Published2017 Oct
ISSN1879-1972
KeywordsAdolescent, Adult, Ambulatory Care Facilities, Continuity of Patient Care, Female, Health Services Accessibility, HIV Infections, Humans, Male, Outcome and Process Assessment (Health Care), Quality Improvement, Transition to Adult Care, United States, Young Adult
Abstract

<p><b>PURPOSE: </b>The HIV Care Continuum highlights the need for HIV-infected youth to be tested, linked, and maintained in lifelong care. Care engagement is important for HIV-infected youth in order for them to stay healthy, maintain a low viral load, and reduce further transmission. One point of potential interruption in the care continuum is during health care transition from adolescent- to adult-centered HIV care. HIV-related health care transition research focuses mainly on youth and on adolescent clinic providers; missing is adult clinic providers' perspectives.</p><p><b>METHODS: </b>We examined health care transition processes through semi-structured interviews with 28 adult clinic staff across Adolescent Trials Network sites. We also collected quantitative data related to clinical characteristics and transition-specific strategies.</p><p><b>RESULTS: </b>Overall, participants described health care transition as a "warm handoff" and a collaborative effort across adolescent and adult clinics. Emergent transition themes included adult clinical care culture (e.g., patient responsibility), strategies for connecting youth to adult care (e.g., adolescent clinic staff attending youth's first appointment at adult clinic), and approaches to evaluating transition outcomes (e.g., data sharing). Participants provided transition improvement recommendations (e.g., formalized protocols).</p><p><b>CONCLUSIONS: </b>Using evidence-based research and a quality improvement framework to inform comprehensive and streamlined transition protocols can help enhance the capacity of adult clinics to collaborate with adolescent clinics to provide coordinated and uninterrupted HIV-related care and to improve continuum of care outcomes.</p>

DOI10.1016/j.jadohealth.2017.05.011
Alternate JournalJ Adolesc Health
PubMed ID28754584
PubMed Central IDPMC5898429
Grant ListK01 DA039804 / DA / NIDA NIH HHS / United States
U01 HD040474 / HD / NICHD NIH HHS / United States
U01 HD040533 / HD / NICHD NIH HHS / United States