Transition to adult clinics in youth living with HIV since birth
Bibliographic record
Abstract
For youth living with HIV, transition from childhood to adulthood is also a transition from child to adult HIV health care clinics. Related studies show the more youth are spending time in pediatric services the more difficult the transition is likely to be. It appears many factors can facilitate or cause difficulties in the transition process; including individual factors and environmental factors. In this study we explore the transition process from child to adult HIV health care clinics through personal experiences of young adults infected by perinatal transmission. Within a qualitative chronological (longitudinal) research framework, 18 youth aged from 13 to 22 years participated twice in individual semi-directed interviews within a three year interval at the Centre Maternel et Infantile sur le Sida du CHU Sainte-Justine in Montreal, Canada. At the second interview, 8 participants had gained their majority (18 years or more). Among those, 6 participants were then attending an adult HIV clinic and 2 had abandoned their medical followup. Youth for whom the medications remained meaningful three years later reported continuous trajectories in terms of treatment plan and medical follow-up. In contrast, youth with more troublesome relationships with the medication reported trajectories that were marked by setbacks: they underwent treatment changes involving heavier dosage regimens and more serious side effects, and in many cases they stopped treatment for significant lengths of time. They felt that taking medication was a daily reminder of their HIV status, which differentiated them from their peers. In addition to the meaning attributed to their treatment, relations with caregivers tend to play an important role in the clinical transition process. Youth who reported good treatment adherence and uninterrupted follow up described the same trusting relationship and closeness with their new physician and health care team.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".