Navigating Transition and Staying Healthy: Supporting Youth to Manage their HIV Care
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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

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


Framing the issue
Framing the Issue to Manage their HIV Care

  • 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


Framing the issue1
Framing the Issue to Manage their HIV Care

“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


Framing the issue2
Framing the Issue to Manage their HIV Care

Vijayan et al. AIDS Care 21(10):1222-9


Framing the issue3
Framing the Issue to Manage their HIV Care

Issues to Address Regarding Transition of HIV Care and Support

  • Source: Nachenga et al. (2009)


Evidence of success
Evidence of Success to Manage their HIV Care

  • Limited evidence

  • Success in the United States and Europe

  • Testing of model

    • Botswana

    • Zimbabwe

    • South Africa

    • Zambia


Evidence of success approaches
Evidence of Success/Approaches to Manage their HIV Care


Evidence of success approaches1
Evidence of Success/Approaches to Manage their HIV Care

Source: Hodgson et al. (2011), Jacob and Jearld (2007), and Reiss, Gibson, and Walker (2005).


Evidence of success approaches2
Evidence of Success/Approaches to Manage their HIV Care

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.


Evidence of success approaches3
Evidence of Success/Approaches to Manage their HIV Care

Table 8. The Zvandiri Model for Psychosocial Care for ALHIV from Zimbabwe


Remaining challenges
Remaining Challenges to Manage their HIV Care

  • 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


Remaining challenges1
Remaining Challenges to Manage their HIV Care

  • Who has a voice?

  • Addressing special needs

    • Married/coupled youth

    • Gender

    • Sexual minorities

    • Mental health

    • Substance


Remaining challenges2
Remaining Challenges to Manage their HIV Care

  • Creating an evidence base

  • Sharing successes and challenges

  • Scaling up

  • Fostering local leadership

  • Measuring results

    • Short-term

    • Longitudinal study