Transition to Adult Care for Young People Living with HIV

The purpose of this narrative review is to delineate the challenges of transitioning young people living with HIV (YPLHIV) to adult-based care and to review recent literature including both qualitative and interventional studies focused on the process of transitioning.

A search in PubMed and Embase was conducted using the key words "adolescent." "young adult," "transition to adult care," "HIV," and "AIDS," including only articles published from 2019 onwards. Conference proceedings from major peer-reviewed conferences focused on YPLHIV were manually searched for studies from January 2021 to December 2023. Data extraction included variables such as study type, participant ages, location, and, for intervention studies, detailed descriptions and outcomes, which were further categorized into themes. Results are included in Table 1 and Table 2.

Experts still debate about what a successful transition means which makes studying it harder. Challenges to successful transition include heterogeneity of the population, inconsistency with transition timing, mobility, and stigma. Recent qualitative studies that elicit feedback from stake holders reveal individual barriers such as lack of self-efficacy and fears of successive disclosures. A major facilitator to successful transition is having youth-friendly services in the adult clinic. Interventional studies emphasize the evidence for transition readiness assessments, transition protocols, mobile health engagement, transition clinics, and health care transition navigation. Health care teams who care for YPLHIV before, during, and after transition need to recognize how vulnerable this population can be. Therefore, transition must be formally addressed and grounded in the local settings and needs. Simple interventions have the potential to improve transition outcomes.