title: "Just take your medicine and everything will be fine": Responsibilisation narratives in accounts of transitioning young people with HIV into adult care services in Australia.
abstract: Young people who have grown up with perinatally acquired HIV in wealthy nations are increasingly transitioning into adult care settings which expect more independence and self-regulation than paediatric care. Drawing on the first qualitative study on growing up with HIV in Australia, this paper examines "responsibilisation" narratives in semi-structured interviews conducted with young people with HIV and their paediatric and adult care providers. Three dominant narratives were identified: responsibilisation as imperative, practice and contest. This suggests that while young people growing up with HIV in an advanced liberal setting such as Australia may value the independence of adult care, and appreciate the need to take responsibility for their health, the practices involved in becoming a responsible health citizen are shaped by individual histories and circumstances, and in some cases, can lead to serious contestation and conflict with care providers. Placing a stronger emphasis on what young people can gain from taking an active role in managing their health may more successfully foster responsibilisation, rather than focusing on what they will lose. Clinicians could benefit from greater support regarding how to engage young people with the elements of responsibilisation likely to resonate more meaningfully at different points in their lives.
authors.affiliation: a Centre for Social Research in Health , UNSW Australia , Sydney , Australia.
authors.forename: Christy E
authors.initials: CE
authors.lastname: Newman
authors.affiliation: a Centre for Social Research in Health , UNSW Australia , Sydney , Australia.
authors.forename: Asha
authors.initials: A
authors.lastname: Persson
authors.affiliation: b Short St Centre Sexual Health Service , South East Sydney Local Health District , Sydney , Australia.|c Paediatric HIV Service , Sydney Children's Hospital , Sydney , Australia.
authors.forename: Angela
authors.initials: A
authors.lastname: Miller
authors.affiliation: a Centre for Social Research in Health , UNSW Australia , Sydney , Australia.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001315:Australia; D005260:Female; D015658:HIV Infections / Q000151:congenital* / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D036301:Qualitative Research; D060305:Transition to Adult Care; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: Australia; HIV social research; Young people; antiretroviral therapy; transition to adult care