TABLE 1

US Department of Health and Human Services Recommendations for Promoting Successful Transition of HIV-Infected Children and Adolescents From Pediatric/Adolescent to Adult Care

Optimize provider communication between adolescent and adult clinics
Address patient/family resistance caused by knowledge deficits, stigma, or disclosure concerns and differences in practice styles
Prepare youth for life-skills development, including counseling them on the appropriate use of a primary care provider and appointment management, the importance of prompt symptom recognition and reporting, and of the importance of self-efficacy with medication management, insurance, and entitlements
Identify an optimal clinic model for a given setting (ie, simultaneous transition of mental health and/or case management versus a gradual phase-in
Implement ongoing evaluation to measure the success of a selected model
Engage in regular multidisciplinary case conferences between adult and adolescent care providers
Implement interventions that may be associated with improved outcomes such as support groups and mental health consultation
Incorporate a family-planning component into clinical care