New Policy For Transitioning HIV-Positive Youth to Adult Care
In response to the effectiveness of antiretroviral therapy allowing most HIV-infected children to survive into adulthood, the American Academy of Pediatrics (AAP) has released a new policy statement advising on the process of transitioning these adolescents from pediatric care to an adult healthcare provider.
The statement breaks the process of transition into 4 major steps, and comes in response to a national survey of AAP members revealing that many pediatricians remain poorly informed of a previous AAP consensus statement detailing transition of children with chronic illness to adult care.
1. First, in collaboration with adult HIV care providers, pediatric healthcare providers should create a written policy describing the goals and timeline of transition.
2. Introduction to the concept of transition should begin in early adolescence, with health care providers encouraging the patient’s personal ownership and management of their own health.
3. The actual transition should be initiated when the patient is between 18 and 25 years old, preceded by a pre-transfer visit once a suitable adult heath care provider has been identified. A transfer letter, medical summary and electronic health records should be provided by the pediatric health care provider.
4. Following the transition, documentation and evaluation of the process and its outcomes should be conducted. The referring provider should remain available to both the adult provider and the patient during and after the process, if necessary.
“A well-planned transition of HIV-infected youth from pediatric, adolescent, or family medicine clinics…enables them to optimize their ability to assume adult roles and activities. Transition planning should be a standard part of providing health care for all HIV-infected youth,” the authors concluded.
“Pediatricians and adolescent and family medicine providers have a pivotal role in facilitating seamless and effective transition at a very vulnerable and anxious time of life for both HIV-infected youth and their families. These essential transitional activities can improve health outcomes for HIV-infected adolescents.”
–Michael Potts
Reference
Chakraborty R, Van Dyke RB. Transitioning HIV-Infected Youth Into Adult Health Care [Published online ahead of print June 24, 2013] Pediatrics. doi: 10.1542/peds.2013-1073. Published June 24,2013. Accessed July 2, 2013.