Beyond “purposeful and planned”: varied trajectories of healthcare transition from pediatric to adult-oriented care among youth living with HIV

ABSTRACTHealthcare transition (HCT) from pediatric to adult-oriented healthcare is ideally conceptualized as a planned, continuous process characterized by communication between multiple stakeholders. However, empirical data is lacking regarding processes through which youth living with HIV (YLHIV) are actually transitioned to adult care. We conducted a qualitative study to gain a more comprehensive understanding of both pediatric and adult provider perspectives on the HCT process for YLHIV. Our study included focus groups discussions with 24 (11 pediatric and 13 adult) providers at a comprehensive HIV care center in the Southeastern United States. Providers described YLHIV and their HCT trajectories as diverse and complex. They described three distinct HCT trajectories: the Ideal Transition, the Abrupt Transition, and the De Facto Transition. Providers agreed that the most important determinant of successful engagement in adult-oriented care (post-HCT) appeared to be consistent prior engagement while in ...