Assessing effectiveness of teen clubs in improving ART outcomes among HIV infected adolescents: A case of Zingwangwa Health Centre
Adolescents and young adults present a growing share of people getting newly infected or living with HIV. Globally, 40% of all new infections occur in adolescents (10-19 years) and young adults (20-24 years). Compared to their adult counterparts, about half of HIV infected adolescents who are on ART...
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| Format: | Thesis |
| Language: | English |
| Published: |
2022
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| Online Access: | http://nkhokwe.kuhes.ac.mw/handle/20.500.12845/601 |
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Add Tag | Summary: | Adolescents and young adults present a growing share of people getting newly infected or living with HIV. Globally, 40% of all new infections occur in adolescents (10-19 years) and young adults (20-24 years). Compared to their adult counterparts, about half of HIV infected adolescents who are on ART are reported to be non-adherent to ART. Further evidence available also suggests that there is little specialized care for adolescents living with HIV as opposed to their adult counterparts. Other studies conducted to measure ART outcomes among adolescents in urban clinics in Zimbabwe showed that adolescents and young adults had high loss to follow up, unlike adults in the same set up
HIV positive adolescents on ART have usually lower viral suppression rates when compared to adults and children, meaning their viral load remains relatively high even though they are on ART. According to spectrum data for 2018, viral load suppression in all ART clients in Malawi was at 89%. A further analysis also indicated that the viral load suppression was different across different age and sex groups. Where as in adults the suppression rates were at above 82%, viral load suppression in children 0 -14 years was at 58%. Additionally, a 2019 study by Umar et al in selected six districts of the southern region of Malawi showed that viral load suppression among adolescents aged 13 – 24 was at 61% Interventions aimed at improving optimal ART uptake among adolescents would therefore go a long way in improving ART outcomes among the adolescents, and one such intervention is teen clubs, implemented in selected health facilities in the country.
The main objective of the study is to assess whether teen clubs as a model of care for HIV and AIDS can improve ART outcomes among infected adolescents.
Using a retrospective analytical cross sectional design, the study assessed ART outcomes among adolescents aged 10 – 24 years attending teen club and those not enrolled in any teen club program, but were enrolled in ART program at Zingwangwa Health Centre. The study employed quantitative data collection and analysis methods. Sample size for study participants was 225 and it was nearly evenly matched for cases (113) and controls (112). This number represented all adolescents aged 10-24 years and on ART at the facility. Patient level data was collected from all the 113 adolescents belonging to the teen club, as well as the 112 adolescents not enrolled in any teen club program but on ART at the health facility. The data was abstracted from patient records such as attendance registers, ART, Defaulter, Viral Load and High Viral Load registers. In addition to the facility registers, viral load results were accessed from Lab Management Information System (LIMS) database for all the adolescents registered at the health center.
Out of the total 225 adolescents enrolled in the study, results showed that 79 adolescents had high viral load (HVL), representing 35% of total adolescents while 146 had low detectable levels (LDL) of viral load (<1000 copies). For the 112 adolescents not enrolled in any teen club program, 44 had high viral load levels (>1000 copies), thus representing about 39% of the total non-teen club adolescents, while 68 had low detectable levels for viral load, which is about 61% of adolescents on ART but not in any teen club program. On the other hand, out of the 113 adolescents enrolled in teen club program at the health center, 35 adolescents had high viral load level, representing about 31% of total adolescents in the program, while a total of 78 adolescent teen club members, representing about 69% had a low detectable viral load level.
Despite results of the study showing that more adolescents enrolled in the teen club reporting to have low viral load levels than their counterparts, calculated p-value of 0.192 and Pearson Chi2 value of 1.7058 suggest there is no strong statistical evidence to suggest an association between viral load level and belonging to a teen club program or not.
In terms of adherence to ART, results show that there was no statistical significant difference in adherence between youths in teen clubs and those not in teen clubs evidenced by p-value being greater than 0.05. (p-value = 0.0814). However, adherence level for youth in the teen club was higher (89.7%) when to compared to that of the youth not belonging to teen club (86.7%)
Results of the study show teen club program is effective in ART care of HIV infected adolescents, demonstrated by better ART outcomes among adolescents that are exposed to teen club program when compared with adolescents not enrolled in teen club program |
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