Exploring Service Delivery Needs for HIV-positive Adolescents

In Kenya, HIV is a leading cause of death for adolescents. Because adolescents tend to have lower rates of retention in care—a key component of treatment success—they are at greater risk for treatment failure, compared to adults and younger children.

A 2014 study of over 22,000 HIV-positive youth and adolescents in Kenya found that 24-month loss to follow up was 32 percent for those on ART. Efforts to better understand and address the unique drivers of retention for HIV-positive adolescents are necessary to reduce the burden of AIDS-related deaths, achieve improved health status, and improve quality of life for HIV-positive adolescents. This information could lead to the development of differentiated service delivery models (DSDM) for adolescents, improving health outcomes and quality of life, while optimizing health facility resources.

Overview

ICAP is beginning a project to inform future service delivery options for HIV-positive adolescents. The project will survey non-pregnant HIV-positive adolescents (aged 10-19) enrolled in HIV care, to identify care preferences as they relate to the service delivery model, and analyze data collected to inform future DSDM for HIV-positive adolescents. Specific objectives include:

  • Identifying preferences of adolescents as they relate to DSDM
  • Identifying adolescent perspectives of the barriers to retention in care
  • Collecting evidence needed to inform a DSDM that will better promote retention in care among HIV-positive adolescents

A survey will be developed in collaboration with staff and HIV-positive adolescent peer educators at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) to explore adolescent preferences regarding key elements of DSDMs such as frequency of visits, setting of services, and provider roles. It will examine basic demographics, and patient perspectives on key elements of the models.

For more information on differentiated service delivery for adolescents, contact Dr. Ruby Fayorsey, ICAP Clinical Advisor, at rf2190@cumc.columbia.edu.

Learn about ICAP’s broader portfolio of work in Kenya.