Transition readiness assessment for young adults living with HIV followed at university teaching hospital of Kigali

INTRODUCTION: Introduction of antiretroviral therapy (ART) worldwide has significantly decreased pediatric mortality from HIV/AIDS. As a result, perinatally-infected children are surviving into adulthood, creating the need to transition of HIV-infected youth from pediatric to adult care. Aims: This study aimed to assess transition readiness of HIV-infected young adults attending a pediatric HIV clinic in Rwanda and then develop a readiness assessment checklist and a transition model. METHODS: This was a qualitative study where in-depth, 20-minute interviews were conducted with 10 HIV-infected young adults (20-24 years) and four healthcare providers. Interviews were conducted in Kinyarwanda, audio taped, transcribed, and then translated into English. The verbatim transcripts were analyzed using content analysis. RESULTS: We undertook 14 interviews-10 young adults and four HCPs. We identified four major themes: self-management behavior, readiness to assume responsibility, barriers to transition, and transition readiness. All young adults had appropriate knowledge about HIV, but only three were able to name their medications or doses. Almost all young adults (90%) refilled their medications themselves. Identified barriers to transition were: fear of losing the relationship with pediatric healthcare providers, fear of new environment, and fear of stigma in adult clinic. These results were used to develop a transition readiness assessment checklist and transition model. CONCLUSION: We identified potential barriers to transition that must be addressed before the transition process begins. The perceived readiness to transition care among the young adults was low, and this could be addressed by implementing a healthcare transition protocol.