“The pediatric social worker really shepherds them through the process”: Care team members' roles in transitioning adolescents and young adults with HIV to adult care

Abstract

Increasing numbers of adolescents and young adults (AYA) with HIV need to transition from pediatric to adult infectious disease care. Little research has examined the roles of the care team members in the transition process. Nineteen pediatric and adult providers with experience caring for HIV-infected AYA were interviewed to explore their perspectives on the roles of care team members on multidisciplinary pediatric and adult infectious disease teams. Interviews were transcribed and coded for emergent themes by independent reviewers. All care team members played important roles in the transition process. Qualitative analyses indicated that pediatric social workers played an especially pivotal role in facilitating the transition of AYA with HIV from pediatric to adult care. Pediatric social workers communicated with other providers and prepared the adolescent and family for the upcoming transition. Both pediatric and adult social workers engaged in assessment of psychosocial functioning and facilitated referrals to community resources. Social workers in the adult infectious disease clinic helped the adolescent and family adjust to the new setting. Pediatric medical providers supported the patient and family during transition and communicated pertinent medical information to the family and medical provider in the adult clinic. Participants stated that the role of the adult medical provider was to welcome the newly transition adolescent into the clinic and to obtain a new comprehensive medical history including sexual behavior. Findings offer insight into the roles held by various members of teams associated with the transition of AYA living with HIV from pediatric to adult care. The effectiveness of medical care teams can influence the quality of care provided to patients and can be improved by understanding team roles.