Healthcare Transition From Pediatric to Adult Care Among Youth Living With HIV in South Carolina: Retrospective Study From 2005 to 2021

PURPOSE: As more youth with HIV (YWH) survive into adulthood, successful healthcare transition (HCT) from pediatric to adult care is crucial for optimal health outcomes. This study aimed to characterize YWH transition status and identify individual- and county-level predictors. METHODS: Statewide HIV surveillance data in South Carolina were used for analysis. The first outcome, "ever transition," indicated whether a patient had at least one adult HIV care visit after the last pediatric care before age 26. Among those who transitioned, a successful transition was defined as timely linkage and retention in care. Logistic regression models identified individual and county-level predictors of HCT outcomes. RESULTS: Among 658 YWH, 538 (89.8%) transitioned, with the mean (standard deviation) age at diagnosis being 17.3 (6.02) years and age at first adult transition being 21.8 (2.02) years. Among 493 YWH who ever transitioned, 215 (43.6%) transitioned successfully. YWH ever transitioned were more likely to be diagnosed at an older age (adjusted odds ratio [aOR] = 1.187, 95% confidence interval [CI]: 1.066-1.332) and without a history of psychiatric diagnoses (aOR = .276, 95% CI: .104-.790). Youth with perinatally acquired HIV were more likely to transition successfully than those with nonperinatally acquired HIV (aOR = 4.124, 95% CI: 1.689-10.548), and individuals in counties with higher social vulnerability in socioeconomic status had lower odds of successful transitions (aOR = .693, 95% CI: .491-.968). DISCUSSION: To improve successful HCT, tailored transition plans are needed for youth with nonperinatally acquired HIV and living in economically disadvantaged areas.