Adolescent Coordinated Transition (ACT) to improve health outcomes among young people living with HIV in Nigeria: study protocol for a randomized controlled trial

Sam-Agudu, Nadia A.; Pharr, Jennifer R.; Bruno, Tamara; Cross, Chad L.; Cornelius, Llewellyn J.; Okonkwo, Prosper; Oyeledun, Bolanle; Khamofu, Hadiza; Olutola, Ayodotun; Erekaha, Salome; Menson, William Nii Ayitey; Ezeanolue, Echezona E.

doi:10.1186/s13063-017-2347-z

Cited by 24 publications

(22 citation statements)

References 35 publications

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“…The increasing availability and effectiveness of ART worldwide, has resulted in more children and adolescents living longer with HIV [7,8]. However, it is well-documented that adolescents struggle to initiate, remain engaged, and consistently adhere to ART [9,10].…”

Section: Introductionmentioning

confidence: 99%

Psychosocial Support Interventions for Improved Adherence and Retention in ART care for Young People Living with HIV (10-24 years): A Scoping Review

Okonji

Mukumbang

Orth

et al. 2020

Preprint

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Background: Mental health disorders such as high levels of anxiety, isolation, depression and suicide ideation reported among young people living with HIV (10-24 years; YPLWH) contribute significantly to poor medication adherence and retention in care. While there is evidence supporting the role of psychosocial support interventions in promoting adherence and retention in antiretroviral treatment (ART) among adults living with HIV, there is little evidence on the role of psychosocial support on medication adherence among YPLWH . This scoping review was designed to identify and classify the types and effects of psychosocial support interventions designed to improve adherence and retention in ART among adolescents and young people living with HIV globally.Method: We searched six electronic databases (i.e., Scopus, Pubmed and EBSCOHost (Academic Search Premier, CINAHL, Psycarticles and Medline). Six relevant articles published between 2011 and 2019 met our inclusion criteria. We extracted information relevant to the nature and outcomes of the reported interventions using thematic content analysis informed by the Population, Intervention, comparison, outcome, and time (PICOT) framework.Results: Four distinctive treatment modalities that focused on improving ART adherence and retention in care were identified: individual counselling, support groups, family-centered services, and treatment supporters.Conclusion: There is a dearth of psychosocial support interventions to improve adherence and retention in ART amongst adolescents and young adults living with HIV. Future research and programming should seek to address psychosocial support interventions or approaches specifically designed to address the needs of adolescents and young adults living with HIV.PROSPERO: Registration CRD42018105057

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Section: Introductionmentioning

confidence: 99%

Psychosocial Support Interventions for Improved Adherence and Retention in ART care for Young People Living with HIV (10-24 years): A Scoping Review

Okonji

Mukumbang

Orth

et al. 2020

Preprint

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“…Among facilities surveyed across Nigeria, our study found routine practices bearing similarities to the major models of adolescent transition/transfer described in the literature [ 29 ]: transition between distinct pediatric and adult HIV providers and services; transition between the same providers/clinic with or without a family-centered approach, and transition utilizing adolescent transition clinics.…”

Section: Discussionmentioning

confidence: 80%

“…At the time of the survey, these HIV treatment centers catered to over 24,000 Nigerian ALHIV aged 10 to 19 years. The survey was conducted as a program evaluation as well as pre-study site assessments to inform the implementation of the Adolescent Coordinated Transition (ACT) study, a National Institutes of Health-funded study on adolescent HIV transitioning in Nigeria [ 29 ].…”

Section: Methodsmentioning

confidence: 99%

Pediatric to adult healthcare transitioning for adolescents living with HIV in Nigeria: A national survey

Badejo¹,

Menson

Sam-Agudu

et al. 2018

PLoS ONE

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IntroductionThe period of transition from pediatric to adult care has been associated with poor health outcomes among 10–19 year old adolescents living with HIV (ALHIV). This has prompted a focus on the quality of transition services, especially in high ALHIV-burden countries. Due to lack of guidelines, there are no healthcare transition standards for Nigeria’s estimated 240,000 ALHIV. We conducted a nationwide survey to characterize routine transition procedures for Nigerian ALHIV.Materials and methodsThis cross-sectional survey was conducted at public healthcare facilities supported by five local HIV service implementing partners. Comprehensive HIV treatment facilities with ≥1 year of HIV service provision and ≥20 ALHIVs enrolled were selected. A structured questionnaire assessed availability of treatment, care and transition services for ALHIV. Transition was defined as a preparatory process catering to the medical, psychosocial, and educational needs of adolescents moving from pediatric to adult care. Comprehensive transition services were defined by 6 core elements: policy, tracking and monitoring, readiness evaluation, planning, transfer of care, and follow-up.ResultsAll 152 eligible facilities were surveyed and comprised 106 (69.7%) secondary and 46 (30.3%) tertiary centers at which 17,662 ALHIV were enrolled. The majority (73, 48.3%) of the 151 facilities responding to the “clinic type” question were family-centered and saw all clients together regardless of age. Only 42 (27.8%) facilities had an adolescent-specific HIV clinic; 53 (35.1%) had separate pediatric/adolescent and adult HIV clinics, of which 39 (73.6%) reported having a transfer/transition policy. Only 6 (15.4%) of these 39 facilities reported having a written protocol. There was a bimodal peak at 15 and 18 years for age of ALHIV transfer to adult care. No surveyed facility met the study definition for comprehensive transition services.ConclusionsFacilities surveyed were more likely to have non-specialized HIV treatment services and had loosely-defined, abrupt transfer versus transition practices, which lacked the core transition elements. Evidence-based standards of transitional care tailored to non-specialized HIV treatment programs need to be established to optimize transition outcomes among ALHIV in Nigeria and in similar settings.

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“…Previous studies in sub-Saharan Africa have described NCD comorbidities in adults living with HIV [44,[109][110][111][112]. Besides mental health [113][114][115][116][117][118][119][120][121] and lung diseases [122][123][124][125][126], few studies have assessed the prevalence of NCDs and particularly NCD risk factors in AYLHIV in SSA other than as incidental ndings [127][128][129][130][131][132][133][134]. Risk behaviour research on AYLHIV in sub-Saharan Africa has predominantly focused on sexual risk behaviour [135].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Non-communicable Diseases and Risk factors in South African Adolescents and Youth Living with HIV: Implications for Integrated Prevention

Kamkuemah¹,

Gausi²,

Oni³

2020

Preprint

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Background Adolescents and youth living with HIV (AYLHIV) face an elevated NCD risk resulting from HIV, psychosocial challenges and the complications of antiretroviral therapy (ART). Methods We conducted a cross-sectional study in six primary care facilities to investigate the prevalence of common NCDs and risk factors among AYLHIV in Cape Town, South Africa between March 2019 and January 2020. We collected information on pre-existent and previously unidentified NCDs and risk factors and collected sociodemographic information of adolescents and youth enrolled for primary HIV care. Characteristics between sexes and age groups were compared using parametric or non-parametric statistical tests. Results Three out of four participants were female, and the median age was 20.5 years (IQR 18.9–22.9). More than a quarter were not in education, employment or training (NEET) and 44% were multidimensionally poor. Our results show an existent burden of hypertension (5%) and central obesity (37%) as well as high levels of depression (43%) and psychological distress symptoms (44%). AYLHIV further self-reported high levels of household food insecurity (70%), low fruit and vegetable consumption, high fast-food and sugar-sweetened beverage intake, low nutritional knowledge and insufficient physical activity. Beyond the NCD risk attributable to HIV and ART, these multiple risk factors coupled with early initiation of high-risk behaviours like smoking, alcohol and drug use, further increase risk. Conclusions Our findings highlight the importance of integrated prevention with NCD risk screening as part of HIV care for AYLHIV and the need for early intervention on social, environmental and economic determinants of NCDs targeting adolescents and youth.

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Adolescent Coordinated Transition (ACT) to improve health outcomes among young people living with HIV in Nigeria: study protocol for a randomized controlled trial

Cited by 24 publications

References 35 publications

Psychosocial Support Interventions for Improved Adherence and Retention in ART care for Young People Living with HIV (10-24 years): A Scoping Review

Psychosocial Support Interventions for Improved Adherence and Retention in ART care for Young People Living with HIV (10-24 years): A Scoping Review

Pediatric to adult healthcare transitioning for adolescents living with HIV in Nigeria: A national survey

Epidemiology of Non-communicable Diseases and Risk factors in South African Adolescents and Youth Living with HIV: Implications for Integrated Prevention

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