Date of Award
Medical Doctor (MD)
Successful public access to antiretroviral therapy in resource-limited settings (RLS) has resulted in survival of HIV perinatally infected children into adulthood. There are few studies on transition of care in RLS, where 90% of HIV-infected children reside. We aimed to characterize the current landscape of the transfer process of HIV-infected adolescents in one such RLS, Jamaica. We conducted in-depth interviews of 18 HIV-infected adolescents in pediatric care and 21 health care providers. We analyzed the data using the grounded theory approach. Five themes emerged: 1. Pediatric clinics were like families who provided care-taking and developmental support in addition to HIV care. 2. Participants felt the quality of care adolescents received in the pediatric clinic was better than it would be in the adult setting. 3. Given the social significance of pediatrics clinics in participants’ lives, alongside the concerns regarding adult care, there was rootedness in the pediatric clinic. 4. In the face of the national policy of transfer to adult care at 13, some physicians sought to bridge the gap between childhood and adulthood by providing adolescent-centered services. 5. Narratives speak to the transfer as a critical juncture in adolescents’ care and a transition as holistic process. We conclude that a formal process of transition is necessary.
De Souza, Flavia, "Transitioning Of Hiv-Infected Children From Pediatric To Adult Care: A Jamaican Case Study" (2016). Yale Medicine Thesis Digital Library. 2046.