Challenges faced by HIV-positive youth transitioning to adult care and evidence-based practices to address them

Key take-home messages

• The barriers to successful transition to adult HIV care include lack of preparation, psychosocial stressors, loss of relationships, stigma, and barriers within the adult health care system (communication, distance to travel, differences from the pediatric environment).
• Factors facilitating successful transition to adult care include formal transition processes, preparation and readiness, adequate timing, adequate communication between pediatric and adult-care clinicians, and support from peers, family, case managers, and health care professionals.
• Transition planning should be a standard part of care for all youth and young adults, and every patient should have an individualized transition plan. Several toolkits, models, and recommendations on how to manage care transitions are available.
• Transition plans should be developed at least one year in advance, and the pediatric provider should arrange for one or more meetings between the adult care provider and the patient before transfer.
• Developmentally appropriate transition plans must take into account the educational, housing, and employment needs of the patient, and include psychological and case management services.

• Determinants of Health
  • Employment
  • Health services
  • Stigma/discrimination
• Population(s)
  • Children or Youth (less than 18 years old)
  • General HIV+ population
• Engagement and Care Cascade
  • Linkage/engagement in care
  • Retention in care
  • Treatment
• Substance Use
  • Nonmedicinal drugs
• Health Systems
  • Delivery arrangements