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首页> 外文期刊>AIDS care. >We never thought this would happen: transitioning care of adolescents with perinatally acquired HIV infection from pediatrics to internal medicine.
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We never thought this would happen: transitioning care of adolescents with perinatally acquired HIV infection from pediatrics to internal medicine.

机译：我们从未想到会发生这种情况：将围生期获得性HIV感染的青少年的护理从儿科过渡到内科。

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PURPOSE: Transitioning the medical care of children with perinatally acquired HIV from pediatric care to internal medicine practices has become increasingly important as newer therapies prolong survival. The study aims to describe challenges to caring for these adolescents and the potential barriers to transitioning them to internal medicine-based care. METHODS: Qualitative study in which data were gathered from open-ended interviews conducted from November 2005 to April 2006 with 18 adolescents with HIV, 15 of their parents, and 9 pediatric health care providers from the Yale Pediatric AIDS Care Program, New Haven, Connecticut. RESULTS: Issues of stigma played a prominent role in both the challenges to care and barriers to transitioning care. Challenges to care were: (1) poor adherence to medication regimens; (2) adolescent sexuality; and (3) disorganized social environments. Potential barriers to transitioning care were: (1) families' negative perceptions of and experiences with stigma of HIV disease - which undermined the desire to meet new providers; (2) perceived and actual lack of autonomy - pediatric providers feared that staff in adult clinics would demand a level of independence that adolescents did not have; and (3) difficulty letting go of relationships - adolescents, guardians, and providers described a familial relationship and expressed anxiety about terminating their relationships. CONCLUSION: Understanding these challenges and barriers can inform both pediatric and adult HIV care providers and enable them to create successful transition programs, with the goal of improving retention and follow-up to care.
机译：目的：随着新疗法延长生存期，将围产期感染艾滋病毒的儿童的医疗从儿科护理过渡到内科治疗变得越来越重要。这项研究旨在描述照顾这些青少年所面临的挑战，以及将他们过渡到以内科为主的医疗服务的潜在障碍。方法：定性研究从2005年11月至2006年4月进行的不限成员名额访谈中收集数据，该访谈来自康涅狄格州纽黑文市耶鲁儿童艾滋病护理计划的18名艾滋病毒青少年，15名父母和9名儿科保健提供者。结果：污名化问题在护理挑战和过渡护理障碍中扮演着重要角色。护理方面的挑战是：（1）服药方案依从性差; （2）青春期性行为; （三）社会环境混乱。过渡医疗的潜在障碍是：（1）家庭对HIV疾病的负面看法和污名化经历-削弱了结识新提供者的渴望; （2）察觉到的和实际的自主权不足-儿科医师担心成人诊所的工作人员会要求青少年具备一定程度的独立性; （3）交往困难-青少年，监护人和提供者描述了家庭关系，并对终止他们的关系表示焦虑。结论：了解这些挑战和障碍可以为儿科和成人HIV护理提供者提供信息，并使他们能够制定成功的过渡计划，以期改善护理的保留率和后续性。

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