Transitioning HIV-infected adolescents to adult care at 14 clinics across the United States
Using adolescent and adult providers’ insights to create multi-level solutions to address transition barriers
Bibliographic Data
HIV-infected adolescents have disproportionately low rates of care retention and viral suppression. Approximately half disengage from care while transitioning to adult clinics, in part due to fragmented care systems and lack of streamlined protocols. We conducted 58 qualitative interviews with social service and health care providers across 14 Adolescent Trials Network clinics (n = 28) and 20 adult clinics that receive transitioning adolescents (n = 30) from August 2015-June 2016. We used the constant comparative approach to examine processes, barriers, and facilitators of adult care transition. Transition barriers coalesced around three levels. Structural: insurance eligibility, transportation, and HIV-related stigma; Clinical: inter-clinic communication, differences in care cultures, and resource/personnel limitations; and Individual: adolescents' transition readiness and developmental capacity. Staff-initiated solutions (e.g., grant-funded transportation) were often unsustainable and applied individual-level solutions to structural-level barriers. Comprehensive initiatives, which develop collaborative policies and protocols that support providers' ability to match the solution and barrier level (i.e., structural-to-structural), are sorely needed. These initiatives should also support local systematic planning to facilitate inter-clinic structures and communication. Such approaches will help HIV-infected adolescents transition to adult care and improve long-term health outcomes
Adult care · Family medicine · Young adult · Adolescent and Pediatric Healthcare · Family Support in Illness · HIV/AIDS Research and Interventions · Medicine · Nursing · Psychology · Gerontology
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Nurses’ and Doctors’ Experiences of Transferring Adolescents or Young Adults With Long-Term Health Conditions From Pediatric to Adult Care
The Intersection Between Women’s Reproductive Desires and HIV Care Providers’ Reproductive Health Practices
Projected Life Expectancy for Adolescents With HIV in the US
The Association between Incarceration and Transactional Sex among HIV-infected Young Men Who Have Sex with Men in the United States
Factors influencing the transition from paediatric to adult HIV care in the Western Cape, South Africa
Feasibility and Acceptability of the Adherence Connection Counseling, Education, and Support (Access) Proof of Concept
Post-transition Care Retention and Viral Suppression Outcomes Among Youth Living with HIV in South Carolina
Beyond “purposeful and planned”
Engagement in care among youth living with parenterally-acquired HIV infection in Romania
Transition of adolescents living with HIV from pediatric to adult care, a retrospective 12-year Single Center Study from the Sahel Region in West-Africa
Stepping up
Suffering, shame, and silence
The Therapeutic Implications of Timely Linkage and Early Retention in HIV Care
Thematic Analysis and Its Reconceptualization as ‘Saliency Analysis’
The Discovery of Grounded Theory
Linkage to and retention in care following healthcare transition from pediatric to adult HIV care
“Youth friendly” clinics
Linking HIV-positive adolescents to care in 15 different clinics across the United States
Factors Affecting Linkage to Care and Engagement in Care for Newly Diagnosed HIV-Positive Adolescents Within Fifteen Adolescent Medicine Clinics in the United States
Managing stigma in adolescent HIV
Association of Race, Substance Abuse, and Health Insurance Coverage With Use of Highly Active Antiretroviral Therapy Among HIV-Infected Women, 2005
Codebook Development for Team-Based Qualitative Analysis
| Citations per year | 1.5 |
|---|---|
| Citation span | 2018 - 2026 (9) |
| Highly cited | No |