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Framing the Issue

Navigating Transition and Staying Healthy: Supporting Youth to Manage their HIV Care Andrew Fullem AIDSTAR-One. Framing the Issue. We should be celebrating Choices to be made Issues Kids are kids Health systems under stress Under-utilized community structures

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Framing the Issue

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  1. Navigating Transition and Staying Healthy: Supporting Youth to Manage their HIV CareAndrew FullemAIDSTAR-One

  2. Framing the Issue • We should be celebrating • Choices to be made • Issues • Kids are kids • Health systems under stress • Under-utilized community structures • Physical and mental factors of clients • The role of care givers

  3. Framing the Issue “A multifaceted, active process that attends to the medical, psychological, and educational or vocational needs of adolescents as they move from the child focused to the adult focused health care ” Reiss and Gibson 2002

  4. Framing the Issue Vijayan et al. AIDS Care 21(10):1222-9

  5. Framing the Issue Issues to Address Regarding Transition of HIV Care and Support • Source: Nachenga et al. (2009)

  6. Evidence of Success • Limited evidence • Success in the United States and Europe • Testing of model • Botswana • Zimbabwe • South Africa • Zambia

  7. Evidence of Success/Approaches

  8. Evidence of Success/Approaches Source: Hodgson et al. (2011), Jacob and Jearld (2007), and Reiss, Gibson, and Walker (2005).

  9. Evidence of Success/Approaches Phase Two: The client and caregiver meet with the provider and discuss the CTC in the contexts of improving self-care, medication independence, adherence, etc. Phase One: The provider begins to discuss the transition process with the client and caregiver using the Comprehensive Transition Checklist (CTC) to review the self-care progress of the adolescent Phase Three: The client has the first checkup without the caregiver at the clinic. The provider and client use the CTC to review self-care goals that include medication independence, adherence, etc. Phase Four: Constant communication and regular follow-up with community care providers that include psychosocial support, mental health, sexual and reproductive health services, disclosure, etc. Adapted from Maturo et al. 2011.

  10. Evidence of Success/Approaches Table 8. The Zvandiri Model for Psychosocial Care for ALHIV from Zimbabwe

  11. Remaining Challenges • The Goal • Holistic care • Meets adolescents where they are • Guides them to a positive future • How to get there • Adolescent centered care • Multidisciplinary programs • Engaging families and care givers

  12. Remaining Challenges • Who has a voice? • Addressing special needs • Married/coupled youth • Gender • Sexual minorities • Mental health • Substance

  13. Remaining Challenges • Creating an evidence base • Sharing successes and challenges • Scaling up • Fostering local leadership • Measuring results • Short-term • Longitudinal study

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