Pediatric to adult healthcare transitioning for adolescents living with HIV in Nigeria: A national survey.
<h4>Introduction</h4>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. D...
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| _version_ | 1850079047101448192 |
|---|---|
| author | Okikiolu A Badejo William N A Menson Nadia A Sam-Agudu Jennifer Pharr Salome Erekaha Tamara Bruno Gift Nwanne Olabanjo Ogunsola Jude Ilozumba Olusegun Busari Echezona E Ezeanolue |
| author_facet | Okikiolu A Badejo William N A Menson Nadia A Sam-Agudu Jennifer Pharr Salome Erekaha Tamara Bruno Gift Nwanne Olabanjo Ogunsola Jude Ilozumba Olusegun Busari Echezona E Ezeanolue |
| author_sort | Okikiolu A Badejo |
| collection | DOAJ |
| description | <h4>Introduction</h4>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.<h4>Materials and methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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. |
| format | Article |
| id | doaj-art-1eb2cb22456b45569cffb3ddcbb4b257 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-1eb2cb22456b45569cffb3ddcbb4b2572025-08-20T02:45:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01136e019880210.1371/journal.pone.0198802Pediatric to adult healthcare transitioning for adolescents living with HIV in Nigeria: A national survey.Okikiolu A BadejoWilliam N A MensonNadia A Sam-AguduJennifer PharrSalome ErekahaTamara BrunoGift NwanneOlabanjo OgunsolaJude IlozumbaOlusegun BusariEchezona E Ezeanolue<h4>Introduction</h4>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.<h4>Materials and methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pone.0198802/1/pone.0198802.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210218%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210218T134533Z&X-Goog-Expires=3600&X-Goog-SignedHeaders=host&X-Goog-Signature=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 |
| spellingShingle | Okikiolu A Badejo William N A Menson Nadia A Sam-Agudu Jennifer Pharr Salome Erekaha Tamara Bruno Gift Nwanne Olabanjo Ogunsola Jude Ilozumba Olusegun Busari Echezona E Ezeanolue Pediatric to adult healthcare transitioning for adolescents living with HIV in Nigeria: A national survey. PLoS ONE |
| title | Pediatric to adult healthcare transitioning for adolescents living with HIV in Nigeria: A national survey. |
| title_full | Pediatric to adult healthcare transitioning for adolescents living with HIV in Nigeria: A national survey. |
| title_fullStr | Pediatric to adult healthcare transitioning for adolescents living with HIV in Nigeria: A national survey. |
| title_full_unstemmed | Pediatric to adult healthcare transitioning for adolescents living with HIV in Nigeria: A national survey. |
| title_short | Pediatric to adult healthcare transitioning for adolescents living with HIV in Nigeria: A national survey. |
| title_sort | pediatric to adult healthcare transitioning for adolescents living with hiv in nigeria a national survey |
| url | https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pone.0198802/1/pone.0198802.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210218%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210218T134533Z&X-Goog-Expires=3600&X-Goog-SignedHeaders=host&X-Goog-Signature=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 |
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