Adolescents growing with HIV/AIDS: experiences of the transition from pediatrics to adult care

Abstract

The main objective of this work is to describe the formation of the Transition Adolescent Clinic (TAC) and understand the process of transitioning adolescents with HIV/AIDS from pediatric to adult care, from the vantage point of individuals subjected to this process. A qualitative method and an intentional sample selected by criteria were adopted for this investigation, which was conducted in São Paulo, Brazil. An in-depth semi-structured interview was conducted with sixteen HIV-infected adolescents who had been part of a transitioning protocol. Adolescents expressed the need for more time to become adapted in the transition process. Having grown up under the care of a team of health care providers made many participants have reluctance toward transitioning. Concerns in moving away from their pediatricians and feelings of disruption, abandonment, or rejection were mentioned. Participants also expressed confidence in the pediatric team. At the same time they showed interest in the new team and expected to have close relationships with them. They also ask to have previous contacts with the adult health care team before the transition. Their talks suggest that they require slightly more time, not the time measured in days or months, but the time measured by constitutive experiences capable of building an expectation of future. This study examines the way in which the adolescents feel, and help to transform the health care transition model used at a public university. Listening to the adolescents' voices is crucial to a better understanding of their needs. They are those who can help the professionals reaching alternatives for a smooth and successful health care transition.

Transition into adult care: factors associated with level of preparedness among adolescents living with HIV in Cambodia

“…Third, these results emphasize calls to take into account adolescents views and experiences regarding specific elements of the transition process [47, 54]. Failure to take adolescents’ perspectives into account leads to routine problematization of adolescents as inadequately equipped to manage transition into adult clinical care [55], yet little research is focused on understanding perspectives of adolescents having difficulties with transition.…”

“…Despite the preparation for transition, most adolescents expressed preference to continue accessing services in pediatric clinics. Although anxiety and reluctance to the transfer into adult clinics is not unusual [28, 37, 39, 51, 54], understanding the underlying reasons why adolescents were dissatisfied with the preparation process will be important in facilitating improvement of the transition preparedness process in the study context.…”

Challenges and facilitators of transition from adolescent to adult HIV care among young adults living with HIV in Moshi, Tanzania

“…The supportive care system becomes synonymous to an external “family,” especially in the context where YLWH are orphaned . Adult services, by contrast, lack peer‐support services, making the transition to adult care a daunting task . Failure of transition results in an adolescent treatment bulge, further straining overburdened adolescent care facilities .…”

Challenges in transitioning adolescents and young adults with rheumatologic diseases to adult Care in a Developing Country - the Brazilian experience

“…In a recently published transition study from our university including sixteen HIV-infected adolescents, the authors noted that the patients required more time for the transition process and feelings of disruption, abandonment, or rejection were common. Many expressed the need to meet with their future health care provider prior to transition [14, 15]. …”