Pediatric-to-Adult HIV Transition Model Shows Mixed Results
The Adolescent and Young Adult (AYA) Healthcare Transition (HCT) clinic — a pediatric-to-adult HIV care model — achieved a high 1-year retention rate but a suboptimal viral suppression rate despite high engagement in care. Ryan White funding and program adaptability emerged as key strengths, while the region's political climate and HIV stigma remained as major barriers.
METHODOLOGY:
AYAs with HIV infection transitioning to adult care face challenges such as low retention and poor viral suppression; AYAHCT clinic was designed to address these issues and improve health outcomes in this population.
Researchers conducted a mixed-methods analysis to evaluate the design, implementation, and early clinical outcomes of the AYAHCT clinic set up within the Adolescent and Young Adult Health Clinic in the Southeastern US.
Quantitative analysis included 18 patients with HIV infection (mean age at first visit, 19.8 years; 78% boys) retrospectively assessed for clinical outcomes including clinic visit attendance, viral suppression, and retention in care.
Qualitative analysis included nine semistructured interviews with key stakeholders in pediatric, AYAHCT, and adult HIV clinics to address facilitators of and barriers to clinic implementation.
TAKEAWAY:
Patients in the AYAHCT clinic averaged 4.4 visits per year, achieved 100% retention in care after 1 year, and had a viral suppression rate of 79.3%.
Among the seven patients who transitioned from the AYAHCT clinic to adult care, retention remained high at 85.7%, with viral suppression improved to 96.8%.
Key facilitators of clinic implementation included Ryan White funding, strong community connections, positive attitudes among providers and staff, and program adaptability.
Major barriers were HIV-related stigma, the region's political climate, clinic workflow challenges, and adverse social determinants of health.
IN PRACTICE:
'Our study described an innovative care model to improve AYA retention in HIV care, with future opportunities to improve VL [viral load] suppression,' the authors wrote.
SOURCE:
This study was led by Nina E. Hill, University of Michigan, Ann Arbor, Michigan. It was published online on July 21, 2025, in AIDS Care.
LIMITATIONS:
This study was limited by its small sample size, affecting the generalizability of the findings. The HIV care model involving both adolescent medicine and HIV specialists may not have been applicable to all settings. Long-term follow-up after transition to the adult HIV clinic was limited.
DISCLOSURES:
This study was supported by the Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center. The authors reported having no potential conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
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