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

Morgan M. Philbin, Amanda E. Tanner, Alice Ma, Brittany D. Chambers, Samuella Ware, Elizabeth N. Kinnard, Sophia A. Hussen, Sonia Lee, J. Fortenberry

Research output: Contribution to journalArticle

7 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)421-427
Number of pages7
JournalAIDS Patient Care and STDs
Volume31
Issue number10
DOIs
StatePublished - Oct 1 2017

Fingerprint

Transition to Adult Care
HIV
Continuity of Patient Care
Patient Transfer
Medication Adherence
Health Status
Prescriptions
Appointments and Schedules
Emotions

Keywords

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

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Adolescent and Adult HIV Providers' Definitions of HIV-Infected Youths' Successful Transition to Adult Care in the United States. / Philbin, Morgan M.; Tanner, Amanda E.; Ma, Alice; Chambers, Brittany D.; Ware, Samuella; Kinnard, Elizabeth N.; Hussen, Sophia A.; Lee, Sonia; Fortenberry, J.

In: AIDS Patient Care and STDs, Vol. 31, No. 10, 01.10.2017, p. 421-427.

Research output: Contribution to journalArticle

Philbin, Morgan M. ; Tanner, Amanda E. ; Ma, Alice ; Chambers, Brittany D. ; Ware, Samuella ; Kinnard, Elizabeth N. ; Hussen, Sophia A. ; Lee, Sonia ; Fortenberry, J. / Adolescent and Adult HIV Providers' Definitions of HIV-Infected Youths' Successful Transition to Adult Care in the United States. In: AIDS Patient Care and STDs. 2017 ; Vol. 31, No. 10. pp. 421-427.
@article{455604a81e4f430c91111b1d75813bc5,
title = "Adolescent and Adult HIV Providers' Definitions of HIV-Infected Youths' Successful Transition to Adult Care in the United States",
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 = "adolescent health, barriers to care, care transition, HIV/AIDS, qualitative, transition success",
author = "Philbin, {Morgan M.} and Tanner, {Amanda E.} and Alice Ma and Chambers, {Brittany D.} and Samuella Ware and Kinnard, {Elizabeth N.} and Hussen, {Sophia A.} and Sonia Lee and J. Fortenberry",
year = "2017",
month = "10",
day = "1",
doi = "10.1089/apc.2017.0131",
language = "English (US)",
volume = "31",
pages = "421--427",
journal = "AIDS Patient Care and STDs",
issn = "1087-2914",
publisher = "Mary Ann Liebert Inc.",
number = "10",

}

TY - JOUR

T1 - Adolescent and Adult HIV Providers' Definitions of HIV-Infected Youths' Successful Transition to Adult Care in the United States

AU - Philbin, Morgan M.

AU - Tanner, Amanda E.

AU - Ma, Alice

AU - Chambers, Brittany D.

AU - Ware, Samuella

AU - Kinnard, Elizabeth N.

AU - Hussen, Sophia A.

AU - Lee, Sonia

AU - Fortenberry, J.

PY - 2017/10/1

Y1 - 2017/10/1

N2 - 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.

AB - 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.

KW - adolescent health

KW - barriers to care

KW - care transition

KW - HIV/AIDS

KW - qualitative

KW - transition success

UR - http://www.scopus.com/inward/record.url?scp=85037714863&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85037714863&partnerID=8YFLogxK

U2 - 10.1089/apc.2017.0131

DO - 10.1089/apc.2017.0131

M3 - Article

C2 - 28981334

AN - SCOPUS:85037714863

VL - 31

SP - 421

EP - 427

JO - AIDS Patient Care and STDs

JF - AIDS Patient Care and STDs

SN - 1087-2914

IS - 10

ER -