Pediatric to adult healthcare transitioning for adolescents living with HIV in Nigeria: A national survey.
PLoS One
; 13(6): e0198802, 2018.
Article
em En
| MEDLINE
| ID: mdl-29894519
ABSTRACT
INTRODUCTION:
The 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 ANDMETHODS:
This 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.RESULTS:
All 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.CONCLUSIONS:
Facilities 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.
Texto completo:
1
Coleções:
01-internacional
Temas:
Atencao_primaria_forma_integrada
Contexto em Saúde:
11_ODS3_cobertura_universal
/
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Equipe de Assistência ao Paciente
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Infecções por HIV
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HIV
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Serviços de Saúde do Adolescente
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Atenção à Saúde
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Transição para Assistência do Adulto
Tipo de estudo:
Guideline
/
Observational_studies
/
Prevalence_studies
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Qualitative_research
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
País/Região como assunto:
Africa
Idioma:
En
Revista:
PLoS One
Ano de publicação:
2018
Tipo de documento:
Article