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The American Academy of Pediatrics
(AAP) has issued a policy statement on how to transition HIV-infected
adolescents to adult healthcare. AAP recommends clinics follow four steps to guide
HIV-positive teens to successfully maintain healthcare: create a formal,
written transition care plan; begin communications about HIV status and
transition when the patient is approximately age 12; make the transition when
the patient is between 18–25 years; and document and evaluate the transition
when it is completed.
The authors, Russell B. Van Dyke,
MD, FAAP, and Rana Chakraborty, MD, of AAP’s Committee on Pediatric AIDS,
contend that pediatricians and adolescent and family medicine providers have
the very important function of arranging a smooth and effective transition at
this difficult time of life for both the HIV-infected youth and their families.
They advise that the written care plan should include supporting documents to
assist the new team, including goals and a timeline. Also an important part of
the plan is a system similar to a registry to track the youths’ progress
through the transition process, to reduce the possibility of a loss of care due
to moving away from the family home.
The plan must include education for
all parties involved and empower the HIV-infected youths to assume
responsibility for their own healthcare. The authors emphasized the importance
of encouraging the adolescent patients’ independence through personally owning
and managing their healthcare. They also advised the pediatrician or family
providers to be aware of and address behavioral, emotional, and mental health
problems.
The plan recommends direct contact
between providers and sending a letter of transition, portable medical summary,
and electronic health records before the transfer. Also, the pediatrician or
family physician should introduce the adolescent patient to the provider
personally. A member of the referring physician’s healthcare team should show support
by contacting the patient periodically and, if necessary, the youth should seek
out a peer support group to help deal with anxiety from the transition. The
plan advised the referring physician to exit once adult care was established.
The full report, “Transitioning
HIV-Infected Youth into Adult Health Care,” was published online in the journal
Pediatrics (2013; doi: 10.1542/peds.2013-1073).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus.
To learn more about The Friends of
AIDS Foundation, please visit: http://www.friendsofaids.org.
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