Transitioning adolescents living with HIV/AIDS to adult-oriented health care: an emerging challenge

Abstract

Objective: To review the literature on transition from pediatric to adult-oriented health care and discuss this issue in the specific context of chronic conditions. Sources: MEDLINE and LILACS were searched for relevant English and French-language articles published between 1990 and 2010. Summary of the findings:The transition of adolescents with chronic diseases from pediatric care to adult-oriented services has been a growing concern among pediatric specialties. In recent years, young people living with HIV/AIDS have begun to reach adulthood, giving rise to several challenges. The studies reviewed herein discuss such relevant topics as: the difference between transfer, an isolated event, and transition, a gradual process; the transition models used in different services; the importance of transitioning in a planned and individualized manner; the need for comprehensive interaction between pediatric and adult-oriented care teams; the importance of joint participation of adolescents, their families, and health professionals in the process; barriers to and factors that promote successful transitions; and the special needs of adolescents with HIV/AIDS in this important period of life. Conclusions:Several authors agree that transitioning adolescents to adult-oriented health care should be a gradual process not determined by age alone. It requires a plan established with ample dialogue among adolescents, their families, and pediatric and adult care teams. However, there is little evidence to support any specific model of health care transition. This should prompt researchers to conduct more prospective studies on the theme, especially in more vulnerable groups such as adolescents living with HIV/AIDS. J Pediatr (Rio J). 2010;86(6):465-472: HIV, adolescents, transition, chronic disease. ResumoObjetivo: Revisar a literatura sobre transição de adolescentes da pediatria para a clínica de adultos, com enfoque na clínica da AIDS, discutindo o tema no contexto das doenças crônicas. Fontes de dados:A pesquisa bibliográfica utilizou os bancos de dados MEDLINE e LILACS , selecionando artigos disponíveis em inglês ou francês. Síntese dos dados:A transição de adolescentes com doenças crô-nicas, sempre atendidos por pediatras, para os serviços de adultos, tem sido uma crescente preocupação nas diversas especialidades pediátricas. Mais recentemente, jovens vivendo com HIV/AIDS estão atingindo essa fase e apresentando diversas dificuldades. Os estudos avaliados nessa revisão discutem alguns tópicos relevantes, como: a diferença entre transferência, um evento isolado, e transição, um processo gradual; os modelos utilizados nos diversos serviços; a importância de a transição ser feita de maneira planejada e individualizada; a necessidade de ampla interação entre as equipes pediátricas e os serviços de adultos; a importância da participação conjunta dos adolescentes, familiares e profissionais de saúde; as barreiras e os fatores que favorecem uma transição bem-sucedida; as necessidades e particularidades dos adolescentes com H...

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

“…While the prominence of age is not necessarily surprising, having been highlighted in other studies [34, 47], these findings do emphasize that tailored, age- and developmental appropriate transition should recognize the evolving capacity of adolescents [45]. This may have a gender-implication given that female adolescents, who generally mature earlier than their male counterparts were older in this study.…”

“…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.…”

Transitioning HIV-Infected Youth Into Adult Health Care

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