title: Transitioning HIV-Positive Adolescents to Adult Care: Lessons Learned From Twelve Adolescent Medicine Clinics.
abstract: To maximize positive health outcomes for youth with HIV as they transition from youth to adult care, clinical staff need strategies and protocols to help youth maintain clinic engagement and medication adherence. Accordingly, this paper describe transition processes across twelve clinics within the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) to provide lessons learned and inform the development of transition protocols to improve health outcomes as youth shift from adolescent to adult HIV care.
  
  
  METHODS
  During a large multi-method Care Initiative program evaluation, three annual visits were completed at each site from 2010-2012 and conducted 174 semi-structured interviews with clinical and program staff (baseline n=64, year 1 n=56, year 2=54).
  
  
  RESULTS
  The results underscore the value of adhering to recent American Academy of Pediatrics (AAP) transition recommendations, including: developing formal transition protocols, preparing youth for transition, facilitating youth's connection to the adult clinic, and identifying necessary strategies for transition evaluation.
  
  
  CONCLUSIONS
  Transitioning youth with HIV involves targeting individual-, provider-, and system-level factors. Acknowledging and addressing key barriers is essential for developing streamlined, comprehensive, and context-specific transition protocols.
  
  
  CONCLUSIONS
  Adolescent and adult clinic involvement in transition is essential to reduce service fragmentation, provide coordinated and continuous care, and support individual and community level health.
authors.affiliation: Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC, USA. Electronic address: aetanner@uncg.edu.
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Tanner
authors.affiliation: HIV Center for Clinical and Behavioral Studies at Columbia University and New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Morgan M
authors.initials: MM
authors.lastname: Philbin
authors.affiliation: Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: DuVal
authors.affiliation: Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD and All Children's Hospital, St. Petersburg, FL, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Ellen
authors.affiliation: Pediatric, Adolescent and Maternal AIDS Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Bill
authors.initials: B
authors.lastname: Kapogiannis
authors.affiliation: Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: J Dennis
authors.initials: JD
authors.lastname: Fortenberry
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy*; D019538:Health Care Surveys; D006801:Humans; D007858:Learning; D008297:Male; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000706:statistics & numerical data; D016730:Program Development; D015397:Program Evaluation; D018570:Risk Assessment; D060305:Transition to Adult Care / Q000458:organization & administration*; D014481:United States; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: Adolescents; HIV; Healthcare; Transition; Young adults