1 Centre for Social Research in Health, The University of New South Wales , Sydney, New South Wales, Australia .
AIDS Patient Care STDS. 2014 Jul;28(7):381-93. doi: 10.1089/apc.2013.0346. Epub 2014 Apr 21.
The first generation of young people with perinatally acquired HIV is moving into adulthood, precipitating a transition from pediatric to adult care. As the first research appraisal of Australian clinician perspectives on this process, this article makes a unique contribution by examining the particular challenges associated with transitioning this population into adult care in regions of low HIV prevalence among young people. Qualitative interviews were conducted with twelve pediatric and adult care clinicians and analyzed for dominant and diverging themes. Clinicians anticipated significant client vulnerabilities during transition and worked beyond the boundaries of their roles and service parameters to keep clients engaged as they moved between pediatric and adult care. Strategies to strengthen the transition process focused on communication and teamwork, informed by and responsive to the needs of individual young people and their families. Clinicians working in settings with very small numbers of young people with HIV must advocate for a hidden minority with little potential for gaining large scale recognition or system changes. New conversations are needed to design a stronger and more sustainable transition process for both young people living with HIV, and their clinicians who care for them, in low prevalence settings.
第一代在围产期感染艾滋病毒的年轻人正在步入成年期，这促使医疗从儿科向成人护理过渡。本文是对澳大利亚临床医生在这一过程中观点的首次研究评估，通过研究在年轻人中艾滋病毒流行率较低的地区将这一人群过渡到成人护理所面临的特殊挑战，做出了独特的贡献。对 12 名儿科和成人护理临床医生进行了定性访谈，并对主要和不同的主题进行了分析。临床医生预计在过渡期间客户会有明显的脆弱性，并超越其角色和服务参数的界限，在客户从儿科护理转移到成人护理时保持他们的参与。加强过渡进程的策略侧重于沟通和团队合作，以个别年轻人及其家庭的需求为依据并做出回应。在年轻人中艾滋病毒感染者人数很少的环境中工作的临床医生必须为这个隐藏的少数群体发声，他们几乎没有获得大规模认可或系统变革的可能性。在低流行率环境中，需要开展新的对话，为感染艾滋病毒的年轻人及其照顾他们的临床医生设计一个更强有力和更可持续的过渡进程。
