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Mulawa MI, Knippler ET, Al-Mujtaba M, Wilkinson TH, Ravi VK, Ledbetter LS. Interventions to Improve Adolescent HIV Care Outcomes. Curr HIV/AIDS Rep 2023; 20:218-230. [PMID: 37300592 PMCID: PMC10528099 DOI: 10.1007/s11904-023-00663-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE OF REVIEW This review of recent studies evaluating interventions to improve HIV care outcomes among adolescents with HIV (AHIV) was conducted to provide a comprehensive overview of the recent evidence, highlight promising approaches, and suggest directions for future research. RECENT FINDINGS Our scoping review revealed 65 studies evaluating a variety of interventions and using a range of study designs at various stages of research. Effective approaches included community-based, integrated service delivery models with case management, trained community adolescent treatment supporters, and consideration of social determinants of health. Recent evidence also supports the feasibility, acceptability, and preliminary efficacy of other innovative approaches, including mental health interventions as well as technology-delivered approaches; however, more research is needed to build the evidence base for these interventions. Our review's findings suggest that interventions providing comprehensive, individualized support are essential to improving HIV care outcomes among adolescents. More research is needed to build the evidence base for such interventions and ensure effective, equitable implementation to support the global target of ending the AIDS epidemic by 2030.
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Affiliation(s)
- Marta I Mulawa
- School of Nursing, Duke University, DUMC 3322, Durham, NC, 27710, USA.
- Duke Global Health Institute, Duke University, Durham, NC, USA.
| | | | - Maryam Al-Mujtaba
- School of Nursing, Duke University, DUMC 3322, Durham, NC, 27710, USA
| | | | | | - Leila S Ledbetter
- Duke University Medical Center Library and Archives, Durham, NC, USA
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Subramanian S, Namusoke-Magongo E, Edwards P, Atujuna M, Chimulwa T, Dow D, Jalil E, Torbunde N, Agot K, Arinaitwe I, Beizer J, Chelwa N, Mbalinda SN, Miti S, Mwangwa F. Integrated Health Care Delivery for Adolescents Living with and at Risk of HIV Infection: A Review of Models and Actions for Implementation. AIDS Behav 2023; 27:50-63. [PMID: 35841465 PMCID: PMC9287816 DOI: 10.1007/s10461-022-03787-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2022] [Indexed: 11/02/2022]
Abstract
Integrated service delivery, providing coordinated services in a convenient manner, is important in HIV prevention and treatment for adolescents as they have interconnected health care needs related to HIV care, sexual and reproductive health and disease prevention. This review aimed to (1) identify key components of adolescent-responsive integrated service delivery in low and middle-income countries, (2) describe projects that have implemented integrated models of HIV care for adolescents, and (3) develop action steps to support the implementation of sustainable integrated models. We developed an implementation science-informed conceptual framework for integrated delivery of HIV care to adolescents and applied the framework to summarize key data elements in ten studies or programs across seven countries. Key pillars of the framework included (1) the socioecological perspective, (2) community and health care system linkages, and (3) components of adolescent-focused care. The conceptual framework and action steps outlined can catalyze design, implementation, and optimization of HIV care for adolescents.
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Affiliation(s)
- Sujha Subramanian
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA.
| | | | - Patrick Edwards
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | - Millicent Atujuna
- Desmond Tutu HIV Foundation, University of Cape Town, Cape Town, South Africa
| | | | - Dorothy Dow
- Duke Global Health Institute, Durham, NC, USA
| | | | | | - Kawango Agot
- Impact Research and Development Organization, Kisumu, Kenya
| | | | - Jenny Beizer
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709, USA
| | | | | | - Sam Miti
- Copperbelt University School of Medicine, Ndola, Zambia
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Boshe J, Brtek V, Beima-Sofie K, Braitstein P, Brooks M, Denison J, Donenberg G, Kemigisha E, Memiah P, Njuguna I, Poku O, Roberts ST, Shayo AM, Dow DE. Integrating Adolescent Mental Health into HIV Prevention and Treatment Programs: Can Implementation Science Pave the Path Forward? AIDS Behav 2023; 27:145-161. [PMID: 36322219 PMCID: PMC9629193 DOI: 10.1007/s10461-022-03876-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 11/06/2022]
Abstract
Adolescent mental health (AMH) is a critical driver of HIV outcomes, but is often overlooked in HIV research and programming. The implementation science Exploration, Preparation, Implementation, Sustainment (EPIS) framework informed development of a questionnaire that was sent to a global alliance of adolescent HIV researchers, providers, and implementors working in sub-Saharan Africa with the aim to (1) describe current AMH outcomes incorporated into HIV research within the alliance; (2) identify determinants (barriers/gaps) of integrating AMH into HIV research and care; and (3) describe current AMH screening and referral systems in adolescent HIV programs in sub-Saharan Africa. Respondents reported on fourteen named studies that included AMH outcomes in HIV research. Barriers to AMH integration in HIV research and care programs were explored with suggested implementation science strategies to achieve the goal of integrated and sustained mental health services within adolescent HIV programs.
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Affiliation(s)
- Judith Boshe
- Department of Mental Health, Kilimanjaro Christian Medical Centre, KCMC Box 3010, Moshi, Tanzania
- Kilimanjaro Christian Medical College University, Moshi, Tanzania
| | | | | | - Paula Braitstein
- University of Toronto, Dalla Lana School of Public Health, Toronto, Canada
- College of Health Sciences, School of Public Health, Moi University, Eldoret, Kenya
| | - Merrian Brooks
- Department of Pediatrics, Craig Dalsimer Division of Adolescent Medicine, Children’s Hospital of Philadelphia, 19104 Philadelphia, PA USA
| | - Julie Denison
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Geri Donenberg
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, Chicago, IL USA
| | - Elizabeth Kemigisha
- Faculty of Interdisciplinary Studies, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Peter Memiah
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD USA
| | - Irene Njuguna
- Department of Global Health, University of Washington, Seattle, WA USA
- Research and Programs, Kenyatta National Hospital, Nairobi, Kenya
| | - Ohemaa Poku
- New York State Psychiatric Institute, HIV Center for Clinical and Behavioral Studies, Columbia University, 10032 New York, NY USA
| | - Sarah T. Roberts
- Women’s Global Health Imperative, RTI International, Berkeley, CA USA
| | - Aisa M. Shayo
- Department of Mental Health, Kilimanjaro Christian Medical Centre, KCMC Box 3010, Moshi, Tanzania
- Kilimanjaro Christian Medical College University, Moshi, Tanzania
| | - Dorothy E. Dow
- Duke Global Health Institute, 27701 Durham, NC USA
- Department of Pediatrics, Infectious Diseases division, Duke University Medical Center, KCMC Box 3010, Box 102346, 27701 Durham, NC USA
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