scholarly journals Transitioning behaviourally infected HIVpositive young people into adult care: Experiences from the young person’s point of view

2013 ◽  
Vol 14 (1) ◽  
pp. 20-24 ◽  
Author(s):  
C Katusiime ◽  
R Parkes-Ratanshi ◽  
A Kambugu
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Young People ◽  
Best Practice ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Care Providers ◽  
Adult Care ◽  
Transition Clinic

Background. There is limited literature on the transition of young people living with HIV/AIDS (YPLHIV) from adolescent/young adult HIV care to adult HIV care in sub-Saharan Africa. Objective. We aimed to share the experiences of HIV-seropositive young adults transitioning into adult care, to inform best practice for such transitioning. Methods. We conducted a retrospective evaluation of the transition of 30 young adults aged ≥25 years from our adolescent/young adult HIV clinic at the Infectious Diseases Institute, Makerere University, Kampala, Uganda, to adult HIV healthcare services between January 2010 and January 2012. Results. Six major themes emerged from the evaluation: (i) adjustment to adult healthcare providers, (ii) the adult clinic logistics, (iii) positive attributes of the adult clinic, (iv) transfer to other health centres, (v) perceived sense of stigma, and (vi) patient-proposed recommendations. A model for transitioning YPLHIV to adult care was proposed. Conclusion. Th ere is a paucity of evidence to inform best practice for transitioning YPLHIV to adult care in resource-limited settings. Ensuring continuity in HIV care and treatment beyond young adult HIV programmes is essential, with provision of enhanced support beyond the transition clinic and youth-friendly approaches by adult-oriented care providers. S Afr J HIV Med 2013;14(1):20-23. DOI:10.7196/SAJHIVMED.885

scholarly journals Transition to adult care: Exploring factors associated with transition readiness among adolescents and young people in adolescent ART clinics in Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249971
Author(s):  
Scovia Nalugo Mbalinda ◽  
Sabrina Bakeera-Kitaka ◽  
Derrick Amooti Lusota ◽  
Philippa Musoke ◽  
Mathew Nyashanu ◽  
...  
Keyword(s):  
Young People ◽  
Tertiary Education ◽  
Multivariate Logistic Regression Analysis ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Transition To Adult Care ◽  
People Living With Hiv ◽  
Adult Care ◽  
Transition Readiness ◽  
Factors Associated

Background Transition readiness refers to a client who knows about his/her illness and oriented towards future goals and hopes, shows skills needed to negotiate healthcare, and can assume responsibility for his/ her treatment, and participate in decision-making that ensures uninterrupted care during and after the care transition to adult HIV care. There is a paucity of research on effective transition strategies. This study explored factors associated with adolescent readiness for the transition into adult care in Uganda. Methods A cross-sectional study was conducted among 786 adolescents, and young people living with HIV randomly selected from 9 antiretroviral therapy clinics, utilizing a structured questionnaire. The readiness level was determined using a pre-existing scale from the Ministry of Health, and adolescents were categorized as ready or not ready for the transition. Bivariate and multivariate analyses were conducted. Results A total of 786 adolescents were included in this study. The mean age of participants was 17.48 years (SD = 4). The majority of the participants, 484 (61.6%), were females. Most of the participants, 363 (46.2%), had no education. The majority of the participants, 549 (69.8%), were on first-line treatment. Multivariate logistic regression analysis found that readiness to transition into adult care remained significantly associated with having acquired a tertiary education (AOR 4.535, 95% CI 1.243–16.546, P = 0.022), trusting peer educators for HIV treatment (AOR 16.222, 95% CI 1.835–143.412, P = 0.012), having received counselling on transition to adult services (AOR 2.349, 95% CI 1.004–5.495, P = 0.049), having visited an adult clinic to prepare for transition (AOR 6.616, 95% CI 2.435–17.987, P = < 0.001) and being satisfied with the transition process in general (AOR 0.213, 95% CI 0.069–0.658, P = 0.007). Conclusion The perceived readiness to transition care among young adults was low. A series of individual, social and health system and services factors may determine successful transition readiness among adolescents in Uganda. Transition readiness may be enhanced by strengthening the implementation of age-appropriate and individualized case management transition at all sites while creating supportive family, peer, and healthcare environments.

scholarly journals Using Theory of Change to inform the design of the HIV+D intervention for integrating the management of depression in routine HIV care in Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259425
Author(s):  
Joshua Ssebunnya ◽  
James Mugisha ◽  
Richard Mpango ◽  
Leticia Kyohangirwe ◽  
Geofrey Taasi ◽  
...  
Keyword(s):  
Sub Saharan Africa ◽  
Theory Of Change ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Successful Implementation ◽  
Care Providers ◽  
Intervention Model ◽  
Levels Of Care ◽  
Intermediate Outcomes ◽  
Causal Pathway

There is growing recognition of the burden of depression in people living with HIV/AIDS (PLWHA), associated with negative behavioural and clinical outcomes. Unfortunately, most HIV care providers in sub-Saharan Africa do not routinely provide mental health services to address this problem. This article describes the process of developing a model for integrating the management of depression in HIV care in Uganda. Theory of Change (ToC) methodology was used to guide the process of developing the model. Three successive ToC workshops were held with a multi-disciplinary group of 38 stakeholders within Wakiso district, in the Central region of Uganda. The first 2 workshops were for generating practical ideas for a feasible and acceptable model of integrating the management of depression in HIV care at all levels of care within the district healthcare system; while the third and final workshop was for consensus building. Following meaningful brainstorming and discussions, the stakeholders suggested improved mental wellbeing among PLWHA as the ultimate outcome of the program. This would be preceded by short-term and intermediate outcomes including reduced morbidity among persons with HIV attributable to depression, allocation of more resources towards management of depression, increased help-seeking among depressed PLWHA and more health workers detecting and managing depression. These would be achieved following several interventions undertaken at all levels of care. The participants further identified some indicators of successful implementation such as emphasis of depression management in the district healthcare plans, increased demand for anti-depressants etc; as well as various assumptions underlying the intervention. All these were graphically aligned in a causal pathway, leading to a ToC map, contextualizing and summarizing the intervention model. The ToC was a valuable methodology that brought together stakeholders to identify key strategies for development of a comprehensible contextualized intervention model for managing depression within HIV care in Uganda; allowing greater stakeholder engagement and buy-in.

scholarly journals Youth-friendly HIV self-testing: Acceptability of campus-based oral HIV self-testing among young adult students in Zimbabwe

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253745
Author(s):  
Andrea L. Koris ◽  
Kearsley A. Stewart ◽  
Tiarney D. Ritchwood ◽  
Daniel Mususa ◽  
Getrude Ncube ◽  
...  
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Young People ◽  
Adult Students ◽  
Hiv Testing ◽  
Hiv Infections ◽  
People Living With Hiv ◽  
School Students ◽  
Self Testing ◽  
Youth Friendly

Background Targeted HIV testing strategies are needed to reach remaining undiagnosed people living with HIV and achieve the UNAIDS’ 95-95-95 goals for 2030. HIV self-testing (HIVST) can increase uptake of HIV testing among young people, but user perspectives on novel distribution methods are uncertain. We assess the acceptability, perceived challenges, and recommendations of young adult lay counselor-led campus-based HIVST delivery among tertiary school students aged 18–24 years in Zimbabwe. Methods We purposively sampled participants from an intervention involving campus-based HIVST using lay workers for distribution. We conducted in-depth interviews (IDIs) and focus group discussions (FGDs) among young adults from 10 universities and colleges in Zimbabwe who: (1) self-tested on campus; (2) self-tested off campus; and (3) opted not to self-test. We audio recorded and transcribed all interviews. Using applied thematic analysis, two investigators identified emergent themes and independently coded transcripts, achieving high inter-coder agreement. Results Of the 52 young adults (53.8% male, 46.1% female) interviewed through 26 IDIs and four FGDs, most IDI participants (19/26, 73%) favored campus-based HIVST, describing it as a more autonomous, convenient, and socially acceptable experience than other facility or community-based HIV testing services. Despite general acceptability, participants identified challenges with this delivery model, including: perceived social coercion, insufficient privacy and access to post-test counseling. These challenges influenced some participants to opt against self-testing (6/52, 11.5%). Recommendations for improved implementation included integrating secondary distribution of test kits and increased HIV counseling options into campus-based programs. Conclusions Barriers to HIV testing among young people are numerous and complex. As the number of new HIV infections among youth continue to grow worldwide, targeted strategies and youth friendly approaches that increase access to testing are needed to close the diagnostic coverage gap. This is the first study to describe young adult acceptance of campus-based delivery of HIVST by lay counselors in Zimbabwe.

scholarly journals Integrating diabetes, hypertension and HIV care in sub-Saharan Africa: a Delphi consensus study on international best practice

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Geoff McCombe ◽  
Sara Murtagh ◽  
Jeffrey V. Lazarus ◽  
Marie Claire Van Hout ◽  
Max Bachmann ◽  
...  
Keyword(s):  
Service Provision ◽  
Chronic Conditions ◽  
Best Practice ◽  
Healthcare Delivery ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Delphi Consensus ◽  
Integrated Healthcare ◽  
Sub Saharan

Abstract Background Although HIV continues to have a high prevalence among adults in sub-Saharan Africa (SSA), the burden of noncommunicable diseases (NCD) such as diabetes and hypertension is increasing rapidly. There is an urgent need to expand the capacity of healthcare systems in SSA to provide NCD services and scale up existing chronic care management pathways. The aim of this study was to identify key components, outcomes, and best practice in integrated service provision for the prevention, identification and treatment of HIV, hypertension and diabetes. Methods An international, multi stakeholder e-Delphi consensus study was conducted over two successive rounds. In Round 1, 24 participants were asked to score 27 statements, under the headings ‘Service Provision’ and ‘Benefits of Integration’, by importance. In Round 2, the 16 participants who completed Round 1 were shown the distribution of scores from other participants along with the score that they attributed to an outcome and were asked to reflect on the score they gave, based on the scores of the other participants and then to rescore if they wished to. Nine participants completed Round 2. Results Based on the Round 1 ranking, 19 of the 27 outcomes met the 70% threshold for consensus. Four additional outcomes suggested by participants in Round 1 were added to Round 2, and upon review by participants, 22 of the 31 outcomes met the consensus threshold. The five items participants scored from 7 to 9 in both rounds as essential for effective integrated healthcare delivery of health services for chronic conditions were improved data collection and surveillance of NCDs among people living with HIV to inform integrated NCD/HIV programme management, strengthened drug procurement systems, availability of equipment and access to relevant blood tests, health education for all chronic conditions, and enhanced continuity of care for patients with multimorbidity. Conclusions This study highlights the outcomes which may form key components of future complex interventions to define a model of integrated healthcare delivery for diabetes, hypertension and HIV in sub-Saharan Africa.

scholarly journals Transitioning from pediatric to adult care and the HIV care continuum in Ghana: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pearl Abaka ◽  
Jerry John Nutor
Keyword(s):  
Health Care Providers ◽  
Community Support ◽  
Transition Process ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Pediatric Care ◽  
Transition To Adult Care ◽  
Care Providers ◽  
Adult Care ◽  
Healthcare Transition

Abstract Background In Sub-Saharan Africa, there are now a significant number of adolescents living with HIV (ALHIV), due to increased access to effective antiretroviral therapy. However, these adolescents are at high risk of dying during the transition to adult care due to various reasons, including lack of preparation for the transition and poor transition arrangements. More knowledge about this issue will lead to a better planned healthcare transition process and preparation for transition from pediatric care to adult care. The aim of this study was to explore the healthcare transitional experiences of ALHIV as they moved from pediatric to adult care. Methods A descriptive exploratory qualitative study was conducted. Purposive sampling method was used to recruit adolescents between 12 and 19 years old. Saturation was realized by the 10th participant. Data were analyzed using thematic content analysis. Results Four main themes emerged from the interview data: the transition process, factors facilitating the transition experience, challenges and coping mechanisms of the ALHIV during transition, and suggestions for improvement based on perceptions on the current transitioning approach. A key finding of this study was the sudden preparation for transition, linked to the absence of a structured transition protocol. Even though age was the main reason for transferring the participants from the pediatric to adult clinic, participants’ age did not influence whether they attended clinic appointment on their own or accompanied by a care provider; it was dependent on the availability of their parents or caregivers. Participants’ parents and adult family caregivers were also integrated into the transition process to some extent. We also found that most of the participants had good patient-provider relationship with their health care providers in both pediatric and adult clinics. Conclusion Findings support the need to develop a structured healthcare transition policy and age-appropriate transition within the clinic environment. There is also a need for social and community support as ALHIV transition from pediatric to adult care.

scholarly journals Cultural and linguistic adaptation of the multi-dimensional OXCAP-MH for outcome measurement of mental health among people living with HIV/AIDS in Uganda: the Luganda version

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Kenneth R. Katumba ◽  
Yoko V. Laurence ◽  
Patrick Tenywa ◽  
Joshua Ssebunnya ◽  
Agata Laszewska ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Care Providers ◽  
English Version ◽  
Validation Process ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background It is rare to find HIV/AIDS care providers in sub-Saharan Africa routinely providing mental health services, yet 8–30% of the people living with HIV have depression. In an ongoing trial to assess integration of collaborative care of depression into routine HIV services in Uganda, we will assess quality of life using the standard EQ-5D-5L, and the capability-based OxCAP-MH which has never been adapted nor used in a low-income setting. We present the results of the translation and validation process for cultural and linguistic appropriateness of the OxCAP-MH tool for people living with HIV/AIDS and depression in Uganda. Methods The translation process used the Concept Elaboration document, the source English version of OxCAP-MH, and the Back-Translation Review template as provided during the user registration process of the OxCAP-MH, and adhered to the Translation and Linguistic Validation process of the OxCAP-MH, which was developed following the international principles of good practice for translation as per the International Society for Pharmacoeconomics and Outcomes Research’s standards. Results The final official Luganda version of the OxCAP-MH was obtained following a systematic iterative process, and is equivalent to the English version in content, but key concepts were translated to ensure cultural acceptability, feasibility and comprehension by Luganda-speaking people. Conclusion The newly developed Luganda version of the OxCAP-MH can be used both as an alternative or as an addition to health-related quality of life patient-reported outcome measures in research about people living with HIV with comorbid depression, as well as more broadly for mental health research.

scholarly journals Broken society, anti-social contracts, failing state? Rethinking youth marginality

2017 ◽  
Author(s):  
Peter Squires ◽  
Carlie Goldsmith
Keyword(s):  
Quality Of Life ◽  
Young Adults ◽  
Young Adult ◽  
Young People ◽  
Political Ideology ◽  
Critical Analysis ◽  
Welfare Policies ◽  
Social Contracts ◽  
Liberal Approach

Peter Squires and Carlie Goldsmith examine social exclusion of youth and the conservative the ideology of the ‘broken society.’ They address young people’s hardship and marginality through a critical analysis of neo-liberal political ideology. They that young adult ‘quality of life’ has diminished as a result of ‘tough justice’ and punitive welfare policies. They question the neo-liberal approach to young adults with its focus on risk and compliance measures while young people receive sanctions, disciplines and punishments.

scholarly journals Evolving Toward Shared HIV Care Using the Champlain BASE eConsult Service

2019 ◽  
Vol 4 (2) ◽  
pp. 238146831986821
Author(s):  
Claire E. Kendall ◽  
Janessa E. Porter ◽  
Esther S. Shoemaker ◽  
Rachel Seoyeon Kang ◽  
Michael Fitzgerald ◽  
...  
Keyword(s):  
At Risk ◽  
Primary Care Providers ◽  
Question Type ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Local Health ◽  
Care Providers ◽  
Patients At Risk ◽  
Survey Responses ◽  
Living With Hiv

Background. Electronic consultation (eConsultation) is a potential strategy to improve access to specialist expertise and facilitate collaborative care models. The Champlain BASE eConsult service allows for asynchronous communication between primary care providers (PCP) and specialists on a secure, web-based system. HIV experts accessible include HIV physician specialists, HIV pharmacists, and social workers with expertise in HIV. Objective. This study aims to describe the use, value, and utility of this eConsultation service in the care of people living with HIV and to characterize the common question types and clinical topics asked by PCPs. Methods. We analyzed the data from eConsults sent to the HIV specialty group in Ontario’s Champlain Local Health Integration Network between February 2015 and December 2017. Usage data and close-out survey responses were analyzed using descriptive statistics, eConsults were classified using a predefined list of validated taxonomy, and a thematic analysis was performed on the consultation logs to identify common clinical themes. Results. Among the 46 eConsults, the most common question type related to drug treatment (58.7%, n = 27) and management (19.6%, n = 9). The main clinical themes involved the care of significant complexities in people living with HIV, such as comorbidities and drug interactions, and suggestions of coordinated patient care. As well, eConsult was used for advice regarding pre-exposure prophylaxis for HIV-negative patients at risk of HIV infection. PCPs highly valued the eConsult service (average rating 4.8/5). Conclusion. Overall, this study demonstrates that eConsult provides an efficient and valuable service to PCPs caring for patients living with or at risk for HIV by improving access to HIV specialists and facilitating the delivery of team-based comprehensive care.

Social networks and the employment of young people leaving care

2017 ◽  
Author(s):  
Xiaoyuan Shang ◽  
Karen R. Fisher
Keyword(s):  
Social Networks ◽  
Young Adults ◽  
Young Adult ◽  
Young People ◽  
Economic Transition ◽  
People With Disabilities ◽  
Job Placement ◽  
Welfare Institutions ◽  
The Government ◽  
Economic Transitions

This chapter illustrates how most young people in Chinese state care become state wards as very young children and have disabilities. When they reach adulthood, many of them remain unemployed. Before the economic transitions in the 1980s, the government provided most of these young people with jobs when they became young adults, or they gained employment in welfare enterprises with tax concessions to employ people with disabilities. After the economic transition, however, many welfare factories reduced their employees or closed down, and state directives for job placement were dismantled. The chapter shows how job placement for young adult orphans has become a challenge for child welfare institutions, and a bottleneck for the support of new children entering state care.

Ethical Problems of Young-Adult Genre and Book Video Bloging, As Formation of a Reading Circle in Modern Youth

2020 ◽  
Vol 9 (1) ◽  
pp. 27-31
Author(s):  
E. Boyarshinova
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Young People ◽  
Young Adult Literature ◽  
Point Of View ◽  
Book Market ◽  
Market Conditions ◽  
Ethical Problems ◽  
Current State ◽  
History Of

This paper examines the history and current state of literature for teenagers. In modern criticism young-adult genre stands out in literature for adolescents. An introductory excursion into the history of the concept of “young adults” and literature for this category of readers is given. Criticism of such works is considered by video bloggers who place their clips on Youtube platform. It is analyzed whether these responses affect the book market conditions. According to the most conservative estimates, more than half of the literature published by major publishers is Young-adult books. They are read not only by teenagers, but also by adults who want to immerse themselves in their youth. The theme of Young-adult literature is serious and multifaceted. It attracted both professional authors, whose works become real literary events, and young, non-professional authors. The study of these works is important from the point of view of studying the sociology of teenage life, to understand what young people live, what problems are reflected in such works, albeit in a crooked mirror.

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