pediatrics
Human Immunodeficiency Virus (HIV) Infection in Infants and Children
Transition to Adult Care
Transition of youth with HIV infection from the pediatric health care model to the adult health care model takes time and advance planning. This process is active and ongoing and does not simply involve a one-time referral to an adult care clinic or office. The pediatric health care model tends to be family-centered, and the care team includes a multidisciplinary team of physicians, nurses, social workers, and mental health professionals; perinatally infected youth may have been cared for by such a team for their entire life. In contrast, the typical adult health care model tends to be individual-centered, and the health care practitioners involved may be located in separate offices requiring multiple visits. Health care practitioners at adult care clinics and offices are often managing high patient volumes, and the consequences of lateness or missed appointments (which may be more common among adolescents) are stricter. Finally, changes in insurance coverage in adolescence or young adulthood can complicate transition of medical care as well. Planning transition over several months and having adolescents have discussions or joint visits with the pediatric and adult health care practitioners can lead to a smoother and more successful transition. A resource for transition of youth with HIV infection into adult health care is available from the American Academy of Pediatrics (seeTransitioning HIV-Infected Youth Into Adult Health Care). 