Transition takes place at a time when young people are experiencing a period of developmental and social change. It is essential to understand the family experience of HIV for young people and the medical and social complexities of having grown up with HIV. Experiences of young people living with HIV in the UK are discussed, including recent data on outcomes post transition, along with experiences of transition for young people living with HIV in other countries and with other chronic illnesses. Challenges and barriers to successful transition and effective approaches are explored. Practice tools and approaches which support successful transition include: assessments of readiness; multidisciplinary support; early preparation; empowerment of young patients; and engaging professionals in adult settings as named 'transition leads'. Establishing successful transition can be critical to ensuring long-term health for young people with perinatally acquired HIV, requiring structured provision, clear processes and good communication between paediatric and adult clinics.