12.2 TRANSITION TO ADULT CARE: ASSESSING PREPAREDNESS FOR YOUTH LIVING WITH HIV

2021 ◽  
Vol 60 (10) ◽  
pp. S18
Author(s):  
Chanda Graves
Keyword(s):  
Transition To Adult Care ◽  
Adult Care ◽  
Youth Living With Hiv ◽  
Living With Hiv

scholarly journals A non-specialist depression care pathway for adolescents living with HIV and transitioning into adult care in Peru: a nested pilot study

2020 ◽  
Author(s):  
Jerome Galea ◽  
Carmen Contreras ◽  
Milagros Wong ◽  
Karen Ramos ◽  
Valentina Vargas ◽  
...  
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Care Pathway ◽  
Hiv Care ◽  
Transition To Adult Care ◽  
Depression Symptom ◽  
Depression Care ◽  
Adult Care ◽  
Small Pilot Study ◽  
Living With Hiv

<p>Adolescents living with HIV (ALWH) are disproportionally impacted by depression and experience worse HIV outcomes compared to other age groups. Integrating depression care with HIV care for ALWH during transition to adult care—an especially crucial time when adolescents frequently disengage from HIV care—holds promise as a strategy for supporting antiretroviral adherence among ALWH, particularly in low- and middle-income countries where >90% of people with HIV live. </p> <p><br>In this brief article, we describe a small pilot study of a simple depression care pathway with psychological first aid delivered by non-mental health specialists for Peruvian ALWH transitioning to adult care. Though small, this is the first study to report on depression symptom prevalence among adolescents living with HIV in Peru and pilot test a depression care pathway that could inform future integration of mental health services with HIV care in Peru.</p>

scholarly journals An evaluation of the effectiveness, facilitators and barriers of HIV Teen Clubs in achieving successful transition from teen to adult care in Blantyre, Malawi using the RE‐AIM Framework.

2020 ◽  
Author(s):  
Jerome Galagade ◽  
Victor Mwapasa
Keyword(s):  
Service Providers ◽  
Implementation Fidelity ◽  
Health Facilities ◽  
Transition Time ◽  
Transition To Adult Care ◽  
Care Transition ◽  
Adult Care ◽  
Factors Associated ◽  
Successful Transition ◽  
Living With Hiv

Abstract Background: High attrition is a major problem for Adolescent Living with HIV (ALHIV) transitioning from pediatric to adult care. Although the HIV Teen Club model has been shown to promote antiretroviral (ARV) adherence and viral suppression among ALHIV, its effect on promoting transitioning ALHIV from pediatric to adult care has not been formally evaluated. We sought to estimate the proportion of ALHIV enrolled in HIV Teen Clubs who successfully transitioned to adult care within six months of the expected transition time and assess health facilities’ fidelity in implementing HIV Teen Clubs’ adult care transition protocols and factors associated with successful transition to adult Care.Methods: From September 2018 to June 2019, we conducted a retrospective descriptive cohort study involving ALHIV attending HIV Teen Clubs in 14 primary health facilities in Blantyre, Malawi who had reached the recommended transition age of 18/19 years between July - December 2017. After obtaining consent, we reviewed their records to assess the proportion who successfully transitioned and also factors associated with transitioning. Checklist was used to ascertain fidelity of implementation of HIV Teen Club transition protocols. In-depth interviews were conducted with service providers (SP) in health facilities providing HIV Teen Club to get their perspectives on reasons for successful or unsuccessful transition.Results: Of the 131 eligible ALHIV enrolled in the study, only 6.9% (n=9) successfully transitioned to adult care within six months of the expected transition time. The overall fidelity in implementing adult care transition protocols in health facilities was medium. There was an association between implementation fidelity and ALHIV successful transition with 2 out of 3 health facilities with high implementation fidelity also successfully transitioning ALHIV into adult care. Successful ALHIV transitioning was associated with urban location of health facilities and ownership of the facilities by NGOs. SPs reported that lack of training in transitioning ALHIV, lack of clear guidelines, inadequate human resource and refusal of ALHIV to transition were some of the health system factors negatively influencing successful transition.Conclusions: Training and mentorship of SP in implementing transitioning protocols and adequately resourcing HIV teen clubs may improve their operations and facilitate successful transitioning.

scholarly journals A non-specialist depression care pathway for adolescents living with HIV and transitioning into adult care in Peru: a nested pilot study

2020 ◽  
Author(s):  
Jerome Galea ◽  
Carmen Contreras ◽  
Milagros Wong ◽  
Karen Ramos ◽  
Valentina Vargas ◽  
...  
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Care Pathway ◽  
Hiv Care ◽  
Transition To Adult Care ◽  
Depression Symptom ◽  
Depression Care ◽  
Adult Care ◽  
Small Pilot Study ◽  
Living With Hiv

<p>Adolescents living with HIV (ALWH) are disproportionally impacted by depression and experience worse HIV outcomes compared to other age groups. Integrating depression care with HIV care for ALWH during transition to adult care—an especially crucial time when adolescents frequently disengage from HIV care—holds promise as a strategy for supporting antiretroviral adherence among ALWH, particularly in low- and middle-income countries where >90% of people with HIV live. </p> <p><br>In this brief article, we describe a small pilot study of a simple depression care pathway with psychological first aid delivered by non-mental health specialists for Peruvian ALWH transitioning to adult care. Though small, this is the first study to report on depression symptom prevalence among adolescents living with HIV in Peru and pilot test a depression care pathway that could inform future integration of mental health services with HIV care in Peru.</p>

scholarly journals An evaluation of the effectiveness, facilitators and barriers of HIV Teen Clubs in achieving successful transition from teen to adult care in Blantyre, Malawi using the RE‐AIM Framework.

2020 ◽  
Author(s):  
Jerome Galagade ◽  
Victor Mwapasa
Keyword(s):  
Service Providers ◽  
Implementation Fidelity ◽  
Health Facilities ◽  
Transition Time ◽  
Transition To Adult Care ◽  
Care Transition ◽  
Adult Care ◽  
Factors Associated ◽  
Successful Transition ◽  
Living With Hiv

Abstract Background: High attrition is a major problem for Adolescent Living with HIV (ALHIV) transitioning from pediatric to adult care. Although the HIV Teen Club model has been shown to promote antiretroviral (ARV) adherence and viral suppression among ALHIV, its effect on promoting transitioning ALHIV from pediatric to adult care has not been formally evaluated. We sought to estimate the proportion of ALHIV enrolled in HIV Teen Clubs who successfully transitioned to adult care within six months of the expected transition time and assess health facilities’ fidelity in implementing HIV Teen Clubs’ adult care transition protocols and factors associated with successful transition to adult Care. Methods: From September 2018 to June 2019, we conducted a retrospective cohort study involving ALHIV attending HIV Teen Clubs in 14 primary health facilities in Blantyre, Malawi who had reached the recommended transition age of 18/19 years between July - December 2017. After obtaining consent, we reviewed their records to assess the proportion who successfully transitioned and also factors associated with transitioning. Checklist was used to ascertain fidelity of implementation of HIV Teen Club transition protocols. In-depth interviews were conducted with service providers (SP) in health facilities providing HIV Teen Club to get their perspectives on reasons for successful or unsuccessful transition.Results: Of the 131 eligible ALHIV enrolled in the study, only 6.9% (n=9) successfully transitioned to adult care within six months of the expected transition time. The overall fidelity in implementing adult care transition protocols in health facilities was medium. There was an association between implementation fidelity and ALHIV successful transition with 2 out of 3 health facilities with high implementation fidelity also successfully transitioning ALHIV into adult care. Successful ALHIV transitioning was associated with urban location of health facilities and ownership of the facilities by NGOs. SPs reported that lack of training in transitioning ALHIV, lack of clear guidelines, inadequate human resource and refusal of ALHIV to transition were some of the health system factors negatively influencing successful transition. Conclusions: Training and mentorship of SP in implementing transitioning protocols and adequately resourcing HIV teen clubs may improve their operations and facilitate successful transitioning.

Pharmacological Considerations When Transitioning the Care of Epilepsy Patients from Pediatric to Adult Epilepsy Centers

2020 ◽  
Vol 09 (04) ◽  
pp. 177-185
Author(s):  
Natalie Guido-Estrada ◽  
Shifteh Sattar
Keyword(s):  
Medication Compliance ◽  
Lifestyle Changes ◽  
Transition To Adult Care ◽  
Pediatric Epilepsy ◽  
Transition Of Care ◽  
Adult Health ◽  
Adult Care ◽  
Adult Model ◽  
Antiepileptic Medications ◽  
The Many

AbstractThere is scarce evidence in review of the available literature to support a clear and superior model for the transition of care for epilepsy patients from pediatric to adult centers. Anecdotally, there is a common perception that families are reluctant to make this change and that the successful transition of care for epilepsy can be a challenge for patients, families, and physicians. As part of the effort to prepare the patient and family for the adult model of care, several treatment issues should be addressed. In this article, we discuss the specific challenges for physicians in transition of care for epilepsy patients from a pharmacological standpoint, which include differences in metabolism and pharmacodynamics that can impact tolerability or efficacy of antiepileptic medications, lifestyle changes affecting medication compliance and seizure control, acquired adult health conditions necessitating new medications that may result in adverse drug interactions, and adult neurologists' potential lack of familiarity with certain medications typically used in the pediatric epilepsy population. We offer this as a guide to avoid one of the many possible pitfalls when epilepsy patients transition to adult care.

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