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AIDS and Behavior
Published in: AIDS and Behavior 4/2019

01-04-2019 | Original Paper

Barriers to Retention in Care are Overcome by Adolescent-Friendly Services for Adolescents Living with HIV in South Africa: A Qualitative Analysis

Authors: Brian C. Zanoni, Thobekile Sibaya, Chelline Cairns, Jessica E. Haberer

Published in: AIDS and Behavior | Issue 4/2019

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Abstract

To assess facilitators and barriers to retention in care for adolescents living with HIV, we conducted in-depth, semi-structured interviews with adolescents ages 13 to 24 years who were living with HIV and being cared for in either an adolescent-friendly or standard government-supported clinic in KwaZulu-Natal, South Africa. We used inductive content analysis approach based on grounded theory derived from reviewing, coding, and interpreting data. We interviewed 28 adolescents living with HIV (16 in the adolescent clinic and 12 from the pediatric clinic) and 14 of their caregivers. Barriers to retention in care included having to attend clinic during school hours, fear of disclosure to others, social isolation, and conflict with clinical staff. Facilitators to retention in care seen in the adolescent-friendly services clinic included after school clinic hours, peer support, and connection to the clinical staff. Adolescent-friendly services are facilitators of HIV care and warrant prioritization in treatment programs.
Literature
1.
2.
3.
Hogwood J, Campbell T, Butler S. I wish I could tell you but I can’t: adolescents with perinatally acquired HIV and their dilemmas around self-disclosure. Clin Child Psychol Psychiatry. 2013;18(1):44–60.CrossRefPubMed
4.
Koenig LJ, Nesheim S, Abramowitz S. Adolescents with perinatally acquired HIV: emerging behavioral and health needs for long-term survivors. Curr Opin Obstet Gynecol. 2011;23(5):321–7.CrossRefPubMed
5.
Maskew M, Brennan AT, MacPhail AP, Sanne IM, Fox MP. Poorer ART outcomes with increasing age at a large public sector HIV clinic in Johannesburg, South Africa. J Int Assoc Physicians AIDS Care (Chic). 2012;11(1):57–65.CrossRef
6.
Evans D, Menezes C, Mahomed K, Macdonald P, Untiedt S, Levin L, et al. Treatment outcomes of HIV-infected adolescents attending public-sector HIV clinics across Gauteng and Mpumalanga, South Africa. AIDS Res Hum Retroviruses. 2013;29(6):892–900.CrossRefPubMedPubMedCentral
7.
Mutevedzi PC, Lessells RJ, Rodger AJ, Newell ML. Association of age with mortality and virological and immunological response to antiretroviral therapy in rural South African adults. PLoS ONE. 2011;6(7):e21795.CrossRefPubMedPubMedCentral
8.
Nglazi MD, Kranzer K, Holele P, Kaplan R, Mark D, Jaspan H, et al. Treatment outcomes in HIV-infected adolescents attending a community-based antiretroviral therapy clinic in South Africa. BMC Infect Dis. 2012;12:21.CrossRefPubMedPubMedCentral
9.
Laher F, Hornschuh S, Otwombe K, Mohapi L, Violari A, Gray G. Outcomes of adolescents and young adults receiving antiretroviral therapy in Soweto, South Africa. 7th IAS Conference on HIV pathogenesis and treatment abstract no MOPE056. 2013. Kuala Lumpur.
10.
Davies MA, Stinson K, Technau K, Phiri S, Rabie H, Wellington M, Giddy J, R, Mofenson L, Moultrie H, editor Outcomes of perinatally HIV-infected adolescents on antiretroviral therapy in Southern Africa. Conference on retrovirology and opportunistic infections (CROI) abstract no: 930. 2014. Boston.
11.
Zanoni BC, Mayer KH. The adolescent and young adult HIV cascade of care in the United States: exaggerated health disparities. AIDS Patient Care STDS. 2014;28(3):128–35.CrossRefPubMedPubMedCentral
12.
Davies MA, Tsondai P, Tiffin N, Eley B, Rabie H, Euvrard J, et al. Where do HIV-infected adolescents go after transfer?—tracking transition/transfer of HIV-infected adolescents using linkage of cohort data to a health information system platform. J Int AIDS Soc. 2017;20(Suppl 3):16–24.
13.
Ryscavage P, Anderson EJ, Sutton SH, Reddy S, Taiwo B. Clinical outcomes of adolescents and young adults in adult HIV care. J Acquir Immune Defic Syndr. 2011;58(2):193–7.CrossRefPubMed
14.
Fish R, Judd A, Jungmann E, O’Leary C, Foster C. Mortality in perinatally HIV-infected young people in England following transition to adult care: an HIV young persons network (HYPNet) audit. HIV Med. 2014;15(4):239–44.CrossRefPubMed
15.
World Health Organization. Making health services adolescent friendly: Developing national quality standards for adolescent-friendly health services. In: Department of Maternal N, Child and Adolescent Health, editor. Geneva: World Health Organization; 2012.
16.
Teasdale CA, Alwar T, Chege D, Fayorsey R, Hawken MP, Abrams EJ. Impact of youth and adolescent friendly services on retention of 10–24-year-olds in HIV care and treatment programs in Nyanza, Kenya. J Acquir Immune Defic Syndr. 2016;71(2):e56–9.CrossRefPubMedPubMedCentral
17.
Tanner AE, Philbin MM, Duval A, Ellen J, Kapogiannis B, Fortenberry JD, et al. “Youth friendly” clinics: considerations for linking and engaging HIV-infected adolescents into care. AIDS Care. 2014;26(2):199–205.CrossRefPubMed
18.
Pettitt ED, Greifinger RC, Phelps BR, Bowsky SJ. Improving health services for adolescents living with HIV in sub-Saharan Africa: a multi-country assessment. Afr J Reprod Health. 2013;17(4 Spec No):17–31.PubMed
19.
Zanoni BC, Sibaya T, Cairns C, Lammert S, Haberer JE. Higher retention and viral suppression with adolescent-focused HIV clinic in South Africa. PLoS ONE. 2017;12(12):e0190260.CrossRefPubMedPubMedCentral
20.
Lee L, Yehia BR, Gaur AH, Rutstein R, Gebo K, Keruly JC, et al. The impact of youth-friendly structures of care on retention among HIV-infected youth. AIDS Patient Care STDS. 2016;30(4):170–7.CrossRefPubMedPubMedCentral
21.
Murray KR, Dulli LS, Ridgeway K, Dal Santo L, de Mora DD, Olsen P, et al. Improving retention in HIV care among adolescents and adults in low- and middle-income countries a systematic review of the literature. PLoS ONE. 2017;12(9):e0184879.CrossRefPubMedPubMedCentral
22.
Zuch M, Mason-Jones AJ, Mathews C, Henley L. Changes to the law on consent in South Africa: implications for school-based adolescent sexual and reproductive health research. BMC Int Health Hum Rights. 2012;12:3.CrossRefPubMedPubMedCentral
23.
Strode A, Slack C, Essack Z. Child consent in South African law: implications for researchers, service providers and policy-makers. S Afr Med J. 2010;100(4):247–9.CrossRefPubMed
24.
South African Marketing Research Association (SAMRA). Guideline for Research with Children in South Africa. In: Research M, editor. Johannesburg: SAMRA; 2015.
25.
Cohen J, Reddington C, Jacobs D, Meade R, Picard D, Singleton K, et al. School-related issues among HIV-infected children. Pediatrics. 1997;100(1):E8.CrossRefPubMed
26.
Anabwani G, Karugaba G, Gabaitiri L. Health, schooling, needs, perspectives and aspirations of HIV infected and affected children in Botswana: a cross-sectional survey. BMC Pediatr. 2016;16:106.CrossRefPubMedPubMedCentral
27.
Funck-Brentano I, Dalban C, Veber F, Quartier P, Hefez S, Costagliola D, et al. Evaluation of a peer support group therapy for HIV-infected adolescents. Aids. 2005;19(14):1501–8.CrossRefPubMed
28.
Menon A, Glazebrook C, Campain N, Ngoma M. Mental health and disclosure of HIV status in Zambian adolescents with HIV infection: implications for peer-support programs. J Acquir Immune Defic Syndr. 2007;46(3):349–54.CrossRefPubMed
29.
Nozyce ML, Lee SS, Wiznia A, Nachman S, Mofenson LM, Smith ME, et al. A behavioral and cognitive profile of clinically stable HIV-infected children. Pediatrics. 2006;117(3):763–70.CrossRefPubMed
30.
Cohen HJ, Papola P, Alvarez M. Neurodevelopmental abnormalities in school-age children with HIV infection. J Sch Health. 1994;64(1):11–3.CrossRefPubMed
31.
32.
Midtbo V, Shirima V, Skovdal M, Daniel M. How disclosure and antiretroviral therapy help HIV-infected adolescents in sub-Saharan Africa cope with stigma. Afr J AIDS Res. 2012;11(3):261–71.CrossRefPubMed
33.
Dickson KE, Ashton J, Smith JM. Does setting adolescent-friendly standards improve the quality of care in clinics? Evidence from South Africa. Int J Qual Health Care. 2007;19(2):80–9.CrossRefPubMed
34.
Berg-Kelly K. Adolescent-friendly services. Acta Paediatr (Oslo, Norway: 1992). 2003;92(11):1241–2.CrossRef
35.
Geng EH, Nash D, Kambugu A, Zhang Y, Braitstein P, Christopoulos KA, et al. Retention in care among HIV-infected patients in resource-limited settings: emerging insights and new directions. Curr HIV/AIDS Rep. 2010;7(4):234–44.CrossRefPubMedPubMedCentral
36.
Thompson MA, Mugavero MJ, Amico KR, Cargill VA, Chang LW, Gross R, et al. Guidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: evidence-based recommendations from an International Association of Physicians in AIDS Care panel. Ann Intern Med. 2012;156(11):817-33, W-284, W-5, W-6, W-7, W-8, W-9, W-90, W-91, W-92, W-93, W-94.
Metadata
Title
Barriers to Retention in Care are Overcome by Adolescent-Friendly Services for Adolescents Living with HIV in South Africa: A Qualitative Analysis
Authors
Brian C. Zanoni
Thobekile Sibaya
Chelline Cairns
Jessica E. Haberer
Publication date
01-04-2019
Publisher
Springer US
Published in
AIDS and Behavior / Issue 4/2019
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-018-2352-6

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