Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
AIDS Research and Therapy
Published in: AIDS Research and Therapy 1/2017

Open Access 01-12-2017 | Research

Transition into adult care: factors associated with level of preparedness among adolescents living with HIV in Cambodia

Authors: Siyan Yi, Chanrith Ngin, Khuondyla Pal, Vohith Khol, Sovannary Tuot, Sokunmealiny Sau, Pheak Chhoun, Gitau Mburu, Sok Chamreun Choub, Kolab Chhim, Penhsun Ly

Published in: AIDS Research and Therapy | Issue 1/2017

Login to get access

Abstract

Background

Preparing adolescents for transition into adult care and supporting their acquisition of self-health care management skills is a critical determinant of their post-transition HIV care outcomes. However, there is a scarcity of research on effective transition strategies. This study explores factors associated with adolescent preparedness for transition into adult care in Cambodia.

Methods

In August 2016, a cross-sectional study was conducted among 223 adolescents living with HIV aged 15–17, randomly selected from 11 antiretroviral therapy clinics, utilizing a structured questionnaire. The level of preparedness was determined using a pre-existing scale, and adolescents were categorized as having a high- or low level of preparedness for transition. Bivariate and multivariate analyses were conducted.

Results

Of 223 adolescents, 55.2% were male, and their mean age was 15.8 years. Overall, 53.3% had a high level of preparedness for transition. As part of the transition protocol, 2.7% had completed a transfer form, 24.7% had a transition case manager, 29.6% had been counselled about the transition, and 19.7% had visited an adult ART clinic. In multivariate analysis, a higher level of preparedness for transition was independently associated with older age (AOR 2.44, 95% CI 1.34–4.46; p = 0.004), family having received social support for their health (AOR 5.32, 95% CI 1.97–14.36; p = 0.001), knowing the kind of treatment they received (ART) (AOR 12.67, 95% CI 2.91–15.19; p = 0.001), trust in friends or family for HIV treatment (AOR 7.82, 95% CI 1.13–8.89; p = 0.008), receiving counseling on transition (AOR 3.17, 95% CI 1.15–8.76; p = 0.03), having a ‘Case Manager’ identified to support them during the preparation process for transition (AOR 3.89, 95% CI 1.08–13.96; p = 0.04), and satisfaction with preparation process for transition in general (AOR 0.35, 95% CI 0.03–0.87; p = 0.01).

Conclusions

A range of individual, social and health system and services factors may determine successful transition preparedness among adolescents in Cambodia. Strengthening implementation of age-appropriate and individualized case management transition at all sites, while creating supportive family, peer, and healthcare environments for adolescent transition is required.
Literature
1.
United Nations Children’s Fund (UNICEF). Turning the tide against AIDS will require more concentrated focus on adolescents and young people. New York: UNICEF; 2016.
2.
Slogrove AL, Mahy M, Armstrong A, Davies MA. Living and dying to be counted: what we know about the epidemiology of the global adolescent HIV epidemic. J Int AIDS Soc. 2017;20(Suppl 3):4–15.PubMed
3.
Ferrand RA, Corbett EL, Wood R, Hargrove J, Ndhlovu CE, Cowan FM, et al. AIDS among older children and adolescents in Southern Africa: projecting the time course and magnitude of the epidemic. AIDS. 2009;23(15):2039–46.CrossRefPubMedPubMedCentral
4.
Porth T, Suzuki C, Gillespie A, Kasedde S, Idele P. Disparities and trends in AIDS mortality among teenagers living with HIV in low- and middle-income countries. 20th International AIDS Conference, Melbourne, Australia; 2014.
5.
Lowenthal ED, Bakeera-Kitaka S, Marukutira T, Chapman J, Goldrath K, Ferrand RA. Perinatally acquired HIV infection in adolescents from sub-Saharan Africa: a review of emerging challenges. Lancet Infect Dis. 2014;14(7):627–39.CrossRefPubMedPubMedCentral
6.
Idele P, Gillespie A, Porth T, Suzuki C, Mahy M, Kasedde S, et al. Epidemiology of HIV and AIDS among adolescents: current status, inequities, and data gaps. J Acquir Immune Defic Syndr. 2014;66(Suppl 2):S144–53.CrossRefPubMed
7.
UNAIDS. Global report. UNAIDS report on the global AIDS epidemic 2013. Geneva: UNAIDS; 2013.
8.
Cruz ML, Cardoso CA, Darmont MQ, Souza E, Andrade SD, D’Al Fabbro MM, et al. Viral suppression and adherence among HIV-infected children and adolescents on antiretroviral therapy: results of a multicenter study. J Pediatr. 2014;90(6):563–71.CrossRef
9.
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
10.
Nachega JB, Hislop M, Nguyen H, Dowdy DW, Chaisson RE, Regensberg L, et al. Antiretroviral therapy adherence, virologic and immunologic outcomes in adolescents compared with adults in southern Africa. J Acquir Immune Defic Syndr. 2009;51(1):65–71.CrossRefPubMedPubMedCentral
11.
Brown LK, Lourie KJ, Pao M. Children and adolescents living with HIV and AIDS: a review. J Child Psychol Psychiatry. 2000;41(1):81–96.CrossRefPubMed
12.
Binagwaho A, Fuller A, Kerry V, Dougherty S, Agbonyitor M, Wagner C, et al. Adolescents and the right to health: eliminating age-related barriers to HIV/AIDS services in Rwanda. AIDS Care. 2012;24(7):936–42.CrossRefPubMed
13.
Siu GE, Bakeera-Kitaka S, Kennedy CE, Dhabangi A, Kambugu A. HIV serostatus disclosure and lived experiences of adolescents at the Transition Clinic of the Infectious Diseases Clinic in Kampala, Uganda: a qualitative study. AIDS Care. 2012;24(5):606–11.CrossRefPubMed
14.
Kim SH, Gerver SM, Fidler S, Ward H. Adherence to antiretroviral therapy in adolescents living with HIV: systematic review and meta-analysis. AIDS. 2014;28(13):1945–56.CrossRefPubMedPubMedCentral
15.
Abubakar A, Van de Vijver FJ, Fischer R, Hassan AS, Gona JK, Dzombo JT, et al. ’Everyone has a secret they keep close to their hearts’: challenges faced by adolescents living with HIV infection at the Kenyan coast. BMC Public Health. 2016;16:197.CrossRefPubMedPubMedCentral
16.
Joint United Nations Programme on HIV/AIDS (UNAIDS). Gap report. Geneva, Switzerland: UNAIDS; 2015.
17.
Lee S, Hazra R. Achieving 90–90–90 in paediatric HIV: adolescence as the touchstone for transition success. J Int AIDS Soc. 2015;18(Suppl 6):20257.PubMedPubMedCentral
18.
Judd A, Sohn AH, Collins IJ. Interventions to improve treatment, retention and survival outcomes for adolescents with perinatal HIV-1 transitioning to adult care: moving on up. Curr Opin HIV AIDS. 2016;11(5):477–86.CrossRefPubMed
19.
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
20.
Bailey H, Cruz MLS, Songtaweesin WN, Puthanakit T. Adolescents with HIV and transition to adult care in the Caribbean, Central America and South America, Eastern Europe and Asia and Pacific regions. J Int AIDS Soc. 2017;20(Suppl 3):50–9.PubMed
21.
Dahourou DL, Gautier-Lafaye C, Teasdale CA, Renner L, Yotebieng M, Desmonde S, et al. Transition from paediatric to adult care of adolescents living with HIV in sub-Saharan Africa: challenges, youth-friendly models, and outcomes. J Int AIDS Soc. 2017;20(Suppl 3):34–49.PubMed
22.
Sohn AH, Vreeman RC, Judd A. Tracking the transition of adolescents into adult HIV care: a global assessment. J Int AIDS Soc. 2017;20(Suppl 3):1–3.
23.
World Health Organization (WHO). HIV and adolescents: guidance for HIV testing and counseling and care for adolescents living with HIV: recommendations for a public health approach and considerations for policy-makers and managers. Geneva, Switzerland: WHO; 2013.
24.
Agwu AL, Fairlie L. Antiretroviral treatment, management challenges and outcomes in perinatally HIV-infected adolescents. J Int AIDS Soc. 2013;16:18579.CrossRefPubMedPubMedCentral
25.
Dowshen N, D’Angelo L. Health care transition for youth living with HIV/AIDS. Pediatrics. 2011;128(4):762–71.CrossRefPubMed
26.
Gilliam PP, Ellen JM, Leonard L, Kinsman S, Jevitt CM, Straub DM. Transition of adolescents with HIV to adult care: characteristics and current practices of the adolescent trials network for HIV/AIDS interventions. J Assoc Nurses AIDS Care. 2011;22(4):283–94.CrossRefPubMed
27.
Hussen SA, Chahroudi A, Boylan A, Camacho-Gonzalez AF, Hackett S, Chakraborty R. Transition of youth living with HIV from pediatric to adult-oriented healthcare: a review of the literature. Future Virol. 2015;9(10):921–9.CrossRefPubMedPubMedCentral
28.
Sharma N, Willen E, Garcia A, Sharma TS. Attitudes toward transitioning in youth with perinatally acquired HIV and their family caregivers. J Assoc Nurses AIDS Care. 2014;25(2):168–75.CrossRefPubMed
29.
Fair CD, Goldstein B, Dizney R. Congruence of transition perspectives between adolescents with perinatally-acquired HIV and their guardians: an exploratory qualitative study. J Pediatr Nurs. 2015;30(5):684–90.CrossRefPubMed
30.
Boudreau ME, Fisher CM. Providing effective medical and case management services to HIV-infected youth preparing to transition to adult care. J Assoc Nurses AIDS Care. 2012;23(4):318–28.CrossRefPubMed
31.
Westling K, Naver L, Vesterbacka J, Belfrage E. Transition of HIV-infected youths from paediatric to adult care, a Swedish single-centre experience. Infect Dis. 2016;48(6):449–52.CrossRef
32.
Ryscavage P, Macharia T, Patel D, Palmeiro R, Tepper V. Linkage to and retention in care following healthcare transition from pediatric to adult HIV care. AIDS Care. 2016;28(5):561–5.CrossRefPubMed
33.
Tanner AE, Philbin MM, DuVal A, Ellen J, Kapogiannis B, Fortenberry JD. Transitioning HIV-positive adolescents to adult Care: lessons learned from twelve adolescent medicine clinics. J Pediatr Nurs. 2016;31(5):537–43.CrossRefPubMedPubMedCentral
34.
Kakkar F, Van der Linden D, Valois S, Maurice F, Onnorouille M, Lapointe N, et al. Health outcomes and the transition experience of HIV-infected adolescents after transfer to adult care in Quebec, Canada. BMC Pediatr. 2016;16:109.CrossRefPubMedPubMedCentral
35.
Mun M, Sopheab H, Tuot S, Morgan P, Pal K, Chhoun P, et al. National HIV sentinel survey among women attending antenatal care clinics in Cambodia in 2014. Phnom Penh: National Center for HIV/AIDS, Dermatology and STD (NCHADS); 2016.
36.
National Center for HIV/AIDS Dermatology and STD (NCHADS). Diagnosis and treatment for HIV infected infant, children and adolescents in Cambodia. Phnom Penh: NCHADS; 2013.
37.
National Center for HIV/AIDS Dermatology and STD (NCHADS). Factors affecting the transition from paediatric to adult HIV care services among children living with HIV aged 12–17 in Cambodia. Phnom Penh: NCHADS; 2012.
38.
Seng SDT, Welle E, Mok S, Soch K, Tep S, et al. Stigma and discrimination as factors affecting the transition from paediatric to adult HIV care services by children living with HIV aged 12–17 in Cambodia: a qualitative exploratory study. Melbourne: International AIDS Conference; 2014.
39.
Chandler C, Ngoksin A. Lost in transitions: current issues faced by adolescents living with HIV in Asia Pacific. Bangkok: UNICEF; 2013.
40.
Henderson RH, Sundaresan T. Cluster sampling to assess immunization coverage: a review of experience with a simplified sampling method. Bull World Health Organ. 1982;60(2):253–60.PubMedPubMedCentral
41.
Skinner J. Probability proportional to size (PPS) sampling. London: Wiley; 2006.CrossRef
42.
Bakeera-Kitaka S, Nabukeera-Barungi N, Nostlinger C, Addy K, Colebunders R. Sexual risk reduction needs of adolescents living with HIV in a clinical care setting. AIDS Care. 2008;20(4):426–33.CrossRefPubMed
43.
New York State Department of Health AIDS Institute. Transitioning HIV-infected adolescents into adult care. NewYork: New York State Department of Health AIDS Institute; 2011.
44.
White AJ, Howland L, Clark MJ. Enhancing acquisition of health care management skills in youth living with HIV prior to transition: a pilot study. J Assoc Nurses AIDS Care. 2015;26(3):296–300.CrossRefPubMed
45.
Wiener LS, Kohrt BA, Battles HB, Pao M. The HIV experience: youth identified barriers for transitioning from pediatric to adult care. J Pediatr Psychol. 2011;36(2):141–54.CrossRefPubMed
46.
Righetti A, Prinapori R, Nulvesu L, Fornoni L, Viscoli C, Di Biagio A. Transitioning HIV-infected children and adolescents into adult care: an Italian real-life experience. J Assoc Nurses AIDS Care. 2015;26(5):652–9.CrossRefPubMed
47.
Machado DM, Succi RC, Turato ER. Transitioning adolescents living with HIV/AIDS to adult-oriented health care: an emerging challenge. J Pediatr. 2010;86(6):465–72.
48.
Mark D, Armstrong A, Andrade C, Penazzato M, Hatane L, Taing L, et al. HIV treatment and care services for adolescents: a situational analysis of 218 facilities in 23 sub-Saharan African countries. J Int AIDS Soc. 2017;20(Suppl 3):25–33.PubMed
49.
Mburu G, Ram M, Oxenham D, Haamujompa C, Iorpenda K, Ferguson L. Responding to adolescents living with HIV in Zambia: a social–ecological approach. Child Youth Serv Rev. 2014;45:9–17.CrossRef
50.
Battles HB, Wiener LS. From adolescence through young adulthood: psychosocial adjustment associated with long-term survival of HIV. J Adolesc Health. 2002;30(3):161–8.CrossRefPubMed
51.
Valenzuela JM, Buchanan CL, Radcliffe J, Ambrose C, Hawkins LA, Tanney M, et al. Transition to adult services among behaviorally infected adolescents with HIV—a qualitative study. J Pediatr Psychol. 2011;36(2):134–40.CrossRefPubMed
52.
Betz CL, Smith KA, Van Speybroeck A, Hernandez FV, Jacobs RA. Movin’ On Up: an innovative nurse-led interdisciplinary health care transition program. J Pediatr Health Care. 2016;30(4):323–38.CrossRefPubMed
53.
Wiener LS, Zobel M, Battles H, Ryder C. Transition from a pediatric HIV intramural clinical research program to adolescent and adult community-based care services: assessing transition readiness. Soc Work Health Care. 2007;46(1):1–19.CrossRefPubMedPubMedCentral
54.
Machado DM, Galano E, de Menezes Succi RC, Vieira CM, Turato ER. Adolescents growing with HIV/AIDS: experiences of the transition from pediatrics to adult care. Braz J Infect Dis. 2016;20(3):229–34.CrossRefPubMed
55.
Persson A, Newman C. When HIV-positive children grow up: a critical analysis of the transition literature in developed countries. Qual Health Res. 2012;22(5):656–67.CrossRefPubMed
Metadata
Title
Transition into adult care: factors associated with level of preparedness among adolescents living with HIV in Cambodia
Authors
Siyan Yi
Chanrith Ngin
Khuondyla Pal
Vohith Khol
Sovannary Tuot
Sokunmealiny Sau
Pheak Chhoun
Gitau Mburu
Sok Chamreun Choub
Kolab Chhim
Penhsun Ly
Publication date
01-12-2017
Publisher
BioMed Central
Published in
AIDS Research and Therapy / Issue 1/2017
Electronic ISSN: 1742-6405
DOI
https://doi.org/10.1186/s12981-017-0159-6

Other articles of this Issue 1/2017

AIDS Research and Therapy 1/2017 Go to the issue

Research

Impaired human immunodeficiency virus type 1 replicative fitness in atypical viremic non-progressor individuals

Research

HIV care in Yangon, Myanmar; successes, challenges and implications for policy

Review

HIV-I Nef inhibitors: a novel class of HIV-specific immune adjuvants in support of a cure

Editorial

HIV vaccine research in Canada

Research

Characterization of occult hepatitis B virus infection among HIV positive patients in Cameroon

Review

Modulation of the strength and character of HIV-specific CD8+ T cell responses with heteroclitic peptides

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24 to hear Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits