In the UK, the expectation now is that children born with HIV will do well on treatment, so their care needs to include planning for their teenage years and adulthood.

The transition process from paediatric to adult care begins after your child has gone through puberty. Your child’s clinic will prepare a plan for making this move, based on your child’s needs and wishes. Preparation can be done gradually, and the transition made when your child feels ready.

Your child may benefit from the support of other young people with HIV during this time. It can be a very good way for them to gain confidence in the management of their HIV. Meeting other young people facing some of the same issues can help reduce isolation, increase self-esteem, and enable them to develop skills in making informed treatment and care decisions. HIV support organisations and clinics can tell you and your child about peer support services, or you can use NAM’s e-atlas or CHIVA’s service finder to see what’s available in your area. CHIVA runs a summer camp for young people with HIV (see http://www.chiva.org.uk/camp/index.html), which offers fun activities as well as the opportunity to talk to peer mentors and other support workers about living with HIV, in a safe environment. This can be particularly useful if you live in an area where there are no regular support groups. Young people have made supportive and long-lasting friendships at these camps.

You may sometimes find it hard to have less involvement in your child’s health care. Making the transition from paediatric to adult HIV care may feel a frightening thought for you and your child.

The transition begins when your child starts to have some sessions with clinic staff without a parent or carer there. Over time, a young person will be given more control over information and decisions about their health. This can be stressful for parents and carers, but it is important for your child’s progression into living with HIV as an adult. Talk to your child’s healthcare team if you have concerns, and ask your child what input they would like or need from you. As young people take more ownership of their health care, they will still want support and guidance. The National Children’s Bureau leaflet for parents and carers of young people with HIV, Their life, has useful information on this process (see http://www.ncb.org.uk/media/874849/their_life.pdf).

Some HIV clinics now have clinics for families and for adolescents. These help to gradually transfer their treatment, care and support to adult HIV services. They can offer services that will help your child adjust to living with HIV as a grown-up, responding to the emotional and practical issues they are likely to encounter.

If there isn’t a specialist clinic, your child will be gradually introduced to an adult HIV clinic. This is likely to happen when your child is between 16 and 18. The transition will start with joint consultations with the paediatrician who has been looking after your child and the doctor who will be taking over their care.

Adult HIV clinics have a different environment to those offering services to children. Obviously, the other patients will all be grown-ups, varying in age from their late teens to advanced old age. The literature on display will be targeted at adults, and there will certainly be information available about sex and how to avoid passing on HIV to sexual partners. But there will still be good support available for your child.

It is not unusual for adherence to medical treatment to become more of a problem during adolescence. Teenagers may be more willing to take risks with their health, to resent having to take treatment each day, and to find it hard to fit taking medication into their daily routine. They may also be more conscious of taking medication around other people who don’t know they have HIV.

You may need to remind them about their HIV treatment more often. Together with clinic staff, you may also have to set up more support to help your child take their treatment for a while. There are various tools your child could use to help remember their treatment schedule, including THT’s Life Plus app (you can find this on www.myhiv.org.uk) or iDiary Meds, an app to help young people with HIV remember their HIV treatment (see www.faithinpeople.co.uk/young-people). Being able to talk to other young people with HIV can be very helpful.

Adolescence can be a difficult and changeable time for any child, and there is some evidence that children with, or affected by, HIV are more likely to become depressed or anxious. Clinic staff will be keeping an eye on your child’s emotional and mental health during this period. Talk to them about any concerns you have about how your child is feeling or coping. There are services and treatments available to help.

As HIV-positive young people approach adulthood, it’s very important that they are provided with information about safe and enjoyable sex. This will include discussions about the physical development of their body, their feelings about intimacy and relationships, and their sexual desires.

It’s also important that there is a discussion of ways of preventing the transmission of HIV to sexual partners, especially safer sex, and how to protect themselves and their partners from other sexually transmitted infections and unwanted pregnancy. Your child will need to understand the legal implications of HIV transmission and how to protect themselves from possible prosecution.

It is very important to reassure your child that they are entitled to, and deserve to have, a normal sex life. You can explain to them that, as long as HIV is controlled by treatment, the risk of transmission to sexual partners is very low.

Many parents find it difficult to talk to their children about sex, and judging the right time to do this is often tricky. These discussions can start whenever you and clinic staff think your child is ready and, as with telling your child about their HIV status, can be done in a staged way. But it is important that your child understands the key information about sexual and reproductive health by the time they are sexually active.

Talking to your child about these issues will not encourage them to have sex, but will empower them and prepare them for a safe and enjoyable sexual life – and to plan for parenthood themselves – if and when the time is right.

Don’t be afraid to look to the clinic staff for advice about how to talk to your child about safer sex and sexuality – it is their job to discuss these issues and they will have had a lot of experience in having this type of conversation. Staff at your child’s HIV clinic will be able to talk through the issues with you and with your child. There may also be times when it is best for your child to talk to clinic staff or an HIV support organisation without you being there. The important thing is that your child has at least one person they can talk openly to about sex and relationships.