COMMENTARY

Transitioning HIV-Infected Adolescents Into Adult Care

Guideline and Commentary

Jacob Abadi, MD; Michael G. Rosenberg, MD, PhD

Disclosures

August 29, 2011

In This Article

Role of the Adult Care Provider During the Transition Period

Recommendations. The adult care provider or multidisciplinary team should:

  • Assign an appropriate clinic staff person to be the primary contact person for newly transitioned adolescents and young adult patients (AIII)

  • Have a plan for identifying and managing problems that could interfere with continuity of care (BIII)

Adult care providers and clinic staff need to be prepared for individual differences in maturity and ability to cope. Some of their young patients will initially require far more support and psychosocial intervention than is customary in adult care settings if they are to transition successfully. Others will have already learned the skills needed to negotiate the healthcare system, appointments, and prescriptions and are eager to become self-sufficient adults. These patients likely only need to be educated about what is expected of them as patients in the new adult care setting.

The adult medical model does not generally allow for the extra time that may be needed for patients who are still learning how to speak for themselves and make mature decisions. The adult care provider and healthcare team should strive to devise ways to provide adequate time for the patient during the transition adjustment period.

Clinicians should strive to have a nonjudgmental approach to patient communication, especially when discussing sexual behaviors. Adolescents/young adults often tend to disengage from care if they feel that they have been spoken to in a judgmental manner.

Adult programs generally have more policies than pediatric and adolescent clinics. Policies for late arrivals and walk-ins should be clearly explained to the adolescent; however, to the extent possible, adult programs should also attempt to be flexible to accommodate the frequently less predictable schedules of adolescents/young adults.

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