Transitioning kids with HIV into adult health care

With more HIV-infected children surviving into adulthood, a formal plan for the process of transitioning these kids from pediatric to adult HIV caregivers needs to be part of their overall health plan, according to a policy statement from the Committee on Pediatric AIDS of the American Academy of Pediatrics (AAP).

The new policy statement, titled “Transitioning HIV-infected youth Into adult health care,” provides specific recommendations for making such a transition as successful as possible and provides means for assessing whether the patient is ready to assume increasing responsibility for his or her own care.

According to the AAP statement, 4 elements are key to any such plan:

1. The referring physician should develop the transition plan and share it with all medical personnel who are or who will be involved in the care of the patient.

2. The plan should be individualized and developed with the participation of the child and family well in advance of the actual transition, ideally in early adolescence. It should include the creation of a portable medical summary and an emergency care plan.

3. It should provide for the patient to meet with the new adult health practitioner or team prior to actually requiring care. A transfer letter and portable medical summary should be brought to the meeting.

4. The entire process should be documented and the pediatric health care provider should remain available as a resource to the new adult health care team during the immediate posttransfer period.

The statement notes that communication between all providers is essential, and that progress surrounding the transition should be tracked, documented, and assessed.

According to the Centers for Disease Control and Prevention, about one-quarter of the 50,000 persons infected with HIV each year are aged between 13 and 24 years. Adolescents and young adults make up 7% of the more than 1 million people in the US living with HIV, and 60% of all young people with HIV do not know they are infected, are not being treated, and can pass the virus to others.