Adolescent to Adult HIV Health Care Transition From the Perspective of Adult Providers in the United States, Amanda E. Tanner, Ph.D., M.P.H. et al., Journal of Adolescent Health 61: 434-49 (2017)

HIV rates in the United States continue to rise among youth (13-24 years) who account for 22% of all new HIV diagnoses. Fewer than half of these youth know their HIV status, only one quarter are engaged in care, and only 6% achieve viral suppression (keeping the amount of virus low, which is necessary for their health), percentages significantly lower than those for adults.  Continuing medical care is crucial for them to stay healthy and reduce further transmission.  However, for youth moving from care provided by adolescent clinics to adult clinics, which is often successful, there is the possibility for interruption in that care.  According to adult clinic staff, adolescents are underprepared to successfully navigate that transition, showing, for example, an inability to refill prescriptions and meet the behavioral expectations of adult clinics. Some adult clinic providers lack training about youth’s unique needs. The authors recommend creating specific collaborative strategies between adult and adolescent clinics to help transitioning adolescents and to more easily share important individual health care data.  

The findings are of significance for LGBTQ youth under the care and custody of the state, who rely on the state for their HIV-related health needs. The state custody context is beyond the scope of this study, and further research is needed for addressing the needs of youth living with HIV either in youth prisons or aging out of foster care, who may have particularized challenges accessing health care and who may not routinely receive the sexual health literacy required to successfully navigate transitioning to receiving care from adult clinics on their own.