title: Bridging worlds, breaking rules: Clinician perspectives on transitioning young people with perinatally acquired HIV into adult care in a low prevalence setting.
abstract: The first generation of young people with perinatally acquired HIV is moving into adulthood, precipitating a transition from pediatric to adult care. As the first research appraisal of Australian clinician perspectives on this process, this article makes a unique contribution by examining the particular challenges associated with transitioning this population into adult care in regions of low HIV prevalence among young people. Qualitative interviews were conducted with twelve pediatric and adult care clinicians and analyzed for dominant and diverging themes. Clinicians anticipated significant client vulnerabilities during transition and worked beyond the boundaries of their roles and service parameters to keep clients engaged as they moved between pediatric and adult care. Strategies to strengthen the transition process focused on communication and teamwork, informed by and responsive to the needs of individual young people and their families. Clinicians working in settings with very small numbers of young people with HIV must advocate for a hidden minority with little potential for gaining large scale recognition or system changes. New conversations are needed to design a stronger and more sustainable transition process for both young people living with HIV, and their clinicians who care for them, in low prevalence settings.
authors.affiliation: 1 Centre for Social Research in Health, The University of New South Wales , Sydney, New South Wales, Australia .
authors.forename: Christy
authors.initials: C
authors.lastname: Newman
authors.forename: Asha
authors.initials: A
authors.lastname: Persson
authors.forename: Angela
authors.initials: A
authors.lastname: Miller
authors.forename: Elena
authors.initials: E
authors.lastname: Cama
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D002648:Child; D003142:Communication; D015658:HIV Infections / Q000151:congenital* / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007407:Interviews as Topic; D010342:Patient Acceptance of Health Care; D010372:Pediatrics; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D060305:Transition to Adult Care