Transitioning from child to adult-oriented HIV clinical care for adolescents living with HIV in Ethiopia: results from a retrospective cohort study

Abstract

Introduction Ethiopia has one of the largest number of adolescents living with HIV (ALHIV). As these adolescents reach adulthood they need to transfer from pediatric to adult-oriented clinics. Clear implementation guidelines for transition are lacking and factors associated with successful transition are inadequately investigated. Our objective was to describe the rate and age of transition from child- to adult-oriented care and the factors associated with transition success among ALHIV in selected health facilities in Ethiopia. Methods a retrospective cohort study of adolescents was conducted in eight health facilities in two regions of Ethiopia: Addis Ababa and the Southern Nations, Nationalities and Peoples´ Region (SNNPR). The study was embedded within a broader study originally aimed at studying clinical outcomes of adolescents. The proportion of adolescents who transitioned was calculated and the association between baseline characteristics and transition was assessed by bivariate and multivariate analysis. Results of 1072 adolescents, 8.7% transitioned to adult care. The most frequent age of transition was 15 (range: 10-22). Multivariate analysis generated two significant findings: adolescents from Addis Ababa were more to likely transitioned than adolescents from SNNPR (aOR: 2.18; 95% CI=1.17-4.06; p<0.01), as well as disclosed adolescents compared to those not disclosed of their HIV-status (aOR: 4.19; 95% CI=1.57-11.98; p<0.01). Conclusion transition occurred in less than 10% of participants, in a wide range of age, indicating a lack of implementation policies regarding the transition process. Thereto, we found that adolescents from Addis Ababa and those disclosed of their disease, were more likely to transition. Further studies are needed to better understand factors associated with transition success.

Antiretroviral therapy abandonment among adolescents and young people with HIV/AIDS during COVID-19: A case-control study

“…So that there is no abandonment of care measures and ART, it is important that care transition is successful, especially when experiencing a pandemic period in which everyday life is permeated by challenges. However, it is known that many adolescents and young people fail to participate in health services during this life phase because they are unaware of the true need for treatment, thus, the transition process is still a difficulty in the HIV care cascade ( 21 ) .…”

Abandono de la terapia antirretroviral entre adolescentes y jóvenes con VIH/SIDA durante el COVID-19: un estudio de casos y controles

“…Sin embargo, se sabe que muchos adolescentes y jóvenes no acuden a los servicios de salud durante esta fase de la vida por desconocer la verdadera necesidad de tratamiento, por lo que el proceso de transición sigue siendo una dificultad en los múltiples cuidados que requiere el VIH (21) .…”

Abandono da terapia antirretroviral entre adolescentes e jovens com HIV/aids durante a COVID-19: estudo caso-controle

“…Para que não haja o abandono de cuidados e da TARV torna-se importante que a transição de cuidados seja bem-sucedida, com destaque quando se vivencia um período pandêmico em que o dia a dia passa ser permeado por desafios. Porém, sabe-se que muitos adolescentes e jovens deixam de participar dos serviços de saúde durante essa fase da vida por não saber a verdadeira necessidade do tratamento, assim, o processo de transição ainda é uma dificuldade na cascata de cuidados do HIV (21) .…”