Social support, HIV self-management improve transition from pediatric to adult care
Improving social support and cultivating the self-management skills of young adults with perinatally acquired HIV can increase retention in care and improve clinical health during their transition to adult care, according to a recent study.
“A growing number of young people in the United States who were born with HIV (perinatal HIV) are now reaching adulthood. As they navigate this transition, they need to begin to transition their health care to an adult health care provider. This transition — which can be best thought of as the process of switching from their pediatric or adolescent doctor and clinical care team to an adult-centered clinical care team — is crucial for the long-term health of these young adults,” Katherine Tassiopoulos, MPH, senior research scientist in the department of epidemiology at the Harvard T.H. Chan School of Public Health, told Infectious Disease News.
“Transition can be a challenging process. Switching providers may be difficult as these young adults often have close, long-term relationships with their pediatric or adolescent care providers. Some may also have mental health problems or cognitive impairment, which can make adhering to medical care difficult. It is therefore essential to study transition and factors that increase its likelihood of success.”
Tassiopoulos and colleagues focused their efforts on young adults aged 18 years or older with perinatally acquired HIV (YPHIV) who were part of the Pediatric HIV/AIDS Cohort Study AMP Up cohort and were approaching or had completed transition from pediatric to adult health care. According to the study, demographic, clinical characteristics and self-reported ability to self-manage health care were compared by transition status, and multivariable logistic regression models examined factors associated with satisfaction and retention in adult clinical care.
Results of the study showed that a majority of the 455 YPHIV reported satisfaction with their clinic and care provider, although many reported non-adherence to antiretroviral medication. According to the study, 124 YPHIV in the cohort transitioned and 56% had periods of unsuppressed HIV-1 RNA in the year before transition. Researchers found that those who transitioned were more likely to report ability to self-manage their health care than those who did not transition. This high self-management was associated with retention after transition (OR = 3.40, 95% CI, 1.33, 9.12), as well as higher perceived emotional social support, the authors concluded.
“We can help young adults living with perinatal HIV to improve the level of emotional support in their lives, and also help them strengthen their ability to self-manage their health care and develop health literacy skills,” Tassiopoulos said. “These modifiable factors can in turn help improve their retention in clinical care, and their overall health, after they transition to adult health care.”– by Caitlyn Stulpin
Disclosures: Tassiopoulos reports receiving a research grant from NIH. Please see the study for all other authors’ relevant financial disclosures.