Transitioning Youth With HIV to Adult HIV Care: Bridging the Gap With Adult Care Clinics for the Life Span

2017 ◽  
Vol 61 (4) ◽  
pp. 407-408
Author(s):  
Patricia A. Garvie
Keyword(s):  
Life Span ◽  
Hiv Care ◽  
Adult Care ◽  
Transitioning Youth

scholarly journals Transition to adult care: Exploring factors associated with transition readiness among adolescents and young people in adolescent ART clinics in Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249971
Author(s):  
Scovia Nalugo Mbalinda ◽  
Sabrina Bakeera-Kitaka ◽  
Derrick Amooti Lusota ◽  
Philippa Musoke ◽  
Mathew Nyashanu ◽  
...  
Keyword(s):  
Young People ◽  
Tertiary Education ◽  
Multivariate Logistic Regression Analysis ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Transition To Adult Care ◽  
People Living With Hiv ◽  
Adult Care ◽  
Transition Readiness ◽  
Factors Associated

Background Transition readiness refers to a client who knows about his/her illness and oriented towards future goals and hopes, shows skills needed to negotiate healthcare, and can assume responsibility for his/ her treatment, and participate in decision-making that ensures uninterrupted care during and after the care transition to adult HIV care. There is a paucity of research on effective transition strategies. This study explored factors associated with adolescent readiness for the transition into adult care in Uganda. Methods A cross-sectional study was conducted among 786 adolescents, and young people living with HIV randomly selected from 9 antiretroviral therapy clinics, utilizing a structured questionnaire. The readiness level was determined using a pre-existing scale from the Ministry of Health, and adolescents were categorized as ready or not ready for the transition. Bivariate and multivariate analyses were conducted. Results A total of 786 adolescents were included in this study. The mean age of participants was 17.48 years (SD = 4). The majority of the participants, 484 (61.6%), were females. Most of the participants, 363 (46.2%), had no education. The majority of the participants, 549 (69.8%), were on first-line treatment. Multivariate logistic regression analysis found that readiness to transition into adult care remained significantly associated with having acquired a tertiary education (AOR 4.535, 95% CI 1.243–16.546, P = 0.022), trusting peer educators for HIV treatment (AOR 16.222, 95% CI 1.835–143.412, P = 0.012), having received counselling on transition to adult services (AOR 2.349, 95% CI 1.004–5.495, P = 0.049), having visited an adult clinic to prepare for transition (AOR 6.616, 95% CI 2.435–17.987, P = < 0.001) and being satisfied with the transition process in general (AOR 0.213, 95% CI 0.069–0.658, P = 0.007). Conclusion The perceived readiness to transition care among young adults was low. A series of individual, social and health system and services factors may determine successful transition readiness among adolescents in Uganda. Transition readiness may be enhanced by strengthening the implementation of age-appropriate and individualized case management transition at all sites while creating supportive family, peer, and healthcare environments.

scholarly journals Transitioning behaviourally infected HIVpositive young people into adult care: Experiences from the young person’s point of view

2013 ◽  
Vol 14 (1) ◽  
pp. 20-24 ◽  
Author(s):  
C Katusiime ◽  
R Parkes-Ratanshi ◽  
A Kambugu
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Young People ◽  
Best Practice ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Care Providers ◽  
Adult Care ◽  
Transition Clinic

Background. There is limited literature on the transition of young people living with HIV/AIDS (YPLHIV) from adolescent/young adult HIV care to adult HIV care in sub-Saharan Africa. Objective. We aimed to share the experiences of HIV-seropositive young adults transitioning into adult care, to inform best practice for such transitioning. Methods. We conducted a retrospective evaluation of the transition of 30 young adults aged ≥25 years from our adolescent/young adult HIV clinic at the Infectious Diseases Institute, Makerere University, Kampala, Uganda, to adult HIV healthcare services between January 2010 and January 2012. Results. Six major themes emerged from the evaluation: (i) adjustment to adult healthcare providers, (ii) the adult clinic logistics, (iii) positive attributes of the adult clinic, (iv) transfer to other health centres, (v) perceived sense of stigma, and (vi) patient-proposed recommendations. A model for transitioning YPLHIV to adult care was proposed. Conclusion. Th ere is a paucity of evidence to inform best practice for transitioning YPLHIV to adult care in resource-limited settings. Ensuring continuity in HIV care and treatment beyond young adult HIV programmes is essential, with provision of enhanced support beyond the transition clinic and youth-friendly approaches by adult-oriented care providers. S Afr J HIV Med 2013;14(1):20-23. DOI:10.7196/SAJHIVMED.885

Resident Training in Transitioning Youth With Epilepsy Into Adult Care

2020 ◽  
Vol 36 (1) ◽  
pp. 60-64
Author(s):  
Francis G. Tirol ◽  
Anagha Kumar
Keyword(s):  
Health Care ◽  
Educational Intervention ◽  
Resident Training ◽  
University Hospital ◽  
Adult Care ◽  
Online Questionnaire ◽  
Transition Care ◽  
Transitioning Youth ◽  
Patients With Epilepsy ◽  
Pediatric Providers

Objective: To appraise the current training of Neurology (N), Pediatric (P), and Med-Peds (MP) residents at MedStar Georgetown University Hospital (MGUH) in providing care to patients with epilepsy who are transitioning from pediatric to adult care. Methods: Through an online questionnaire, we surveyed Neurology, Pediatric, and Med-Peds residents to assess their knowledge, confidence, and experience at transitioning youth with epilepsy to adult-oriented health care. Results: N, P, and MP residents generally rated their knowledge and confidence at providing transition care to youth with epilepsy to be poor; however, P and MP residents rated higher in limited measures of knowledge and experience. Conclusion: Our appraisal of resident training in transitions care for youth with epilepsy has highlighted training elements in our institution that require attention for both adult and pediatric providers, leading to the formulation of an educational intervention that will promote experiential and multimodal approaches in this area.

scholarly journals A non-specialist depression care pathway for adolescents living with HIV and transitioning into adult care in Peru: a nested pilot study

2020 ◽  
Author(s):  
Jerome Galea ◽  
Carmen Contreras ◽  
Milagros Wong ◽  
Karen Ramos ◽  
Valentina Vargas ◽  
...  
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Care Pathway ◽  
Hiv Care ◽  
Transition To Adult Care ◽  
Depression Symptom ◽  
Depression Care ◽  
Adult Care ◽  
Small Pilot Study ◽  
Living With Hiv

<p>Adolescents living with HIV (ALWH) are disproportionally impacted by depression and experience worse HIV outcomes compared to other age groups. Integrating depression care with HIV care for ALWH during transition to adult care—an especially crucial time when adolescents frequently disengage from HIV care—holds promise as a strategy for supporting antiretroviral adherence among ALWH, particularly in low- and middle-income countries where >90% of people with HIV live. </p> <p><br>In this brief article, we describe a small pilot study of a simple depression care pathway with psychological first aid delivered by non-mental health specialists for Peruvian ALWH transitioning to adult care. Though small, this is the first study to report on depression symptom prevalence among adolescents living with HIV in Peru and pilot test a depression care pathway that could inform future integration of mental health services with HIV care in Peru.</p>

scholarly journals Transitioning young adults from paediatric to adult care and the HIV care continuum in Atlanta, Georgia, USA: a retrospective cohort study

2017 ◽  
Vol 20 (1) ◽  
pp. 21848 ◽  
Author(s):  
Sophia A. Hussen ◽  
Rana Chakraborty ◽  
Andrea Knezevic ◽  
Andres Camacho-Gonzalez ◽  
Eugene Huang ◽  
...  
Keyword(s):  
Young Adults ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Adult Care ◽  
Care Continuum

scholarly journals Transition from Pediatric to Adult HIV Care for Young Women Living with HIV

2020 ◽  
Vol 19 ◽  
pp. 232595822090357
Author(s):  
Victoria Logan Kennedy ◽  
Kaitlyn Luisa Mellor ◽  
Jason Brophy ◽  
Ari Bitnun ◽  
Ariane Alimenti ◽  
...  
Keyword(s):  
Young Women ◽  
Child Protection ◽  
Group Home ◽  
Cd4 Count ◽  
Pediatric Hiv ◽  
Hiv Care ◽  
Adult Care ◽  
Factors Affecting ◽  
Women Living With Hiv ◽  
Women With Hiv

Transitioning from pediatric to adult care is a complicated process for youth with chronic illnesses. This study elucidates the unique factors affecting transition preparedness and perception of adult HIV care among a cohort of young women with HIV. Between 2013 and 2015, 48 women with HIV, who had experience with pediatric HIV care, were enrolled in a large Canadian cohort study. Variables were self-reported during peer-administered surveys. Only 60% reported feeling prepared for transition. Having never had contact with child protection services ( P = .049), never been in foster care ( P = .011), never been in a group home ( P = .036), reporting a higher current CD4 count ( P = .033), and reporting a younger ideal age for transition ( P = .041) were associated with transition preparedness. Eighty-four percent reported equivalent or better HIV care following transition. Correlates of equivalent/better care following transition included lower personal income ( P = .023), higher CD4 count ( P = .021), care by an adult infectious diseases specialist ( P = .002), and transition preparedness ( P = .005). Our findings highlight the importance of adequate transition preparation and its effect on perception of care following transition.

scholarly journals A non-specialist depression care pathway for adolescents living with HIV and transitioning into adult care in Peru: a nested, proof of concept pilot study

2021 ◽  
Vol 8 ◽  
Author(s):  
Jerome T. Galea ◽  
Carmen Contreras ◽  
Milagros Wong ◽  
Karen Ramos ◽  
Valentina Vargas ◽  
...  
Keyword(s):  
Care Pathway ◽  
Hiv Care ◽  
Proof Of Concept ◽  
Depression Care ◽  
Adult Care ◽  
Antiretroviral Adherence ◽  
Care Integration ◽  
Patient Health ◽  
Specialized Care ◽  
Living With Hiv

Abstract Background Adolescents living with HIV (ALWH) are disproportionally impacted by depression, experiencing worse HIV outcomes. Integrated depression and HIV care may support antiretroviral adherence. This study pilot tested for proof of concept a basic depression care pathway for ALWH to inform depression care integration with HIV services in Peru. Methods ALWH were screened for depression with the Patient Health Questionnaire-9 (PHQ-9). Participants with PHQ-9 scores of ⩾10 or suicidal ideation (SI) were eligible for Psychological First Aid (PFA) delivered by non-mental health specialists. Participants with PHQ-9 re-assessments of ⩾20 or SI were referred to specialized services. Results Twenty-eight (11 female, 17 male) ALWH aged 15–21 years participated; n = 20 (71%) identified as heterosexual. Most (18/28) acquired HIV at birth. Baseline PHQ-9 scores were 0–4, n = 3 (11%); 5–9, n = 9 (32%); 10–14, n = 10 (36%); 15–19, n = 4 (14%); and 20–27, n = 2 (7%). Eleven participants (40%) reported SI. Among participants with PHQ-9 > 4, 92% (23/25) were not severe. Of the 21 (75%) of participants eligible for PFA, n = 9 (32%) accepted at least one session, of which n = 3 (33%) were linked to specialized care. Conclusions A simple care pathway operationalizing depression screening and non-specialist delivered emotional support is a first step toward integrated depression and HIV care for ALWH.

scholarly journals A non-specialist depression care pathway for adolescents living with HIV and transitioning into adult care in Peru: a nested pilot study

2020 ◽  
Author(s):  
Jerome Galea ◽  
Carmen Contreras ◽  
Milagros Wong ◽  
Karen Ramos ◽  
Valentina Vargas ◽  
...  
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Care Pathway ◽  
Hiv Care ◽  
Transition To Adult Care ◽  
Depression Symptom ◽  
Depression Care ◽  
Adult Care ◽  
Small Pilot Study ◽  
Living With Hiv

<p>Adolescents living with HIV (ALWH) are disproportionally impacted by depression and experience worse HIV outcomes compared to other age groups. Integrating depression care with HIV care for ALWH during transition to adult care—an especially crucial time when adolescents frequently disengage from HIV care—holds promise as a strategy for supporting antiretroviral adherence among ALWH, particularly in low- and middle-income countries where >90% of people with HIV live. </p> <p><br>In this brief article, we describe a small pilot study of a simple depression care pathway with psychological first aid delivered by non-mental health specialists for Peruvian ALWH transitioning to adult care. Though small, this is the first study to report on depression symptom prevalence among adolescents living with HIV in Peru and pilot test a depression care pathway that could inform future integration of mental health services with HIV care in Peru.</p>

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