Challenges and Fears of Adolescents and Young Adults Living with HIV Facing Transition to Adult HIV Care

Ashaba, Scholastic; Zanoni, Brian C.; Baguma, Charles; Tushemereirwe, Patricia; Nuwagaba, Gabriel; Kirabira, Joseph; Nansera, Denis; Maling, Samuel; Tsai, Alexander C.

doi:10.1007/s10461-022-03856-6

Cited by 4 publications

(1 citation statement)

References 45 publications

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“…One explanation that has been offered for the poor treatment outcomes during this critical transition period is that adolescents and young adults (who have, either since birth or since acquiring HIV, received HIV care through a much more hands-on, directive, and/or paternalistic model of pediatric care) often lack the necessary self-management skills to advocate for themselves in the adult HIV clinics and navigate care on their own [11][12][13]. Further challenges limiting the ability of the AYLPHIV to gain the necessary skills and become independent include HIV stigma, fear of HIV status disclosure, lack of self-efficacy, and poverty [10,[14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

A qualitative analysis of self-management needs of adolescents and young adults living with perinatally acquired HIV in rural, southwestern Uganda

Ashaba,

Baguma,

Tushemereirwe

et al. 2024

PLOS Glob Public Health

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The number of adolescents living with HIV remains high in sub-Saharan Africa with poorer HIV treatment outcomes among adolescents and young adults compared to individuals in other age groups. For adolescents and young adults living with perinatally acquired HIV (AYLPHIV), the transition from pediatric to adult HIV care is a particularly high-risk period. We conducted a qualitative study to understand self-management needs of AYLPHIV in rural, southwestern Uganda as they prepare to transition to adult HIV care in order to inform relevant interventions that can enable AYLPHIV acquire the necessary skills to manage their illness as they age into adulthood. We conducted 60 in-depth interviews with AYLPHIV (n = 30), caregivers (n = 20) and health care providers (n = 10) from the HIV clinic at Mbarara Regional Referral Hospital. We used an interview guide that focused on perceptions about transition to adult HIV care, challenges with transitioning, navigating HIV care, and self-management needs for AYLPHIV (from the perspectives of AYLPHIV, their caregivers, and health care providers). We used thematic analysis to identify themes related to AYLPHIV’s self-management skills. We identified several self-management needs that we grouped under two major themes; social support and empowerment for AYLPHIV to assume responsibility for their own health and to navigate adult HIV care independently. The sub-themes under social support were information support, instrumental support, and emotional support as the sub themes while sub-themes under empowerment included self-advocacy skills, interpersonal skills, self-care skills, and disclosure skills. Taken together, these findings indicate that AYLPHIV need to be supported and empowered to maximize their chances of successfully transitioning to adult HIV care. Support comes from peers and caregivers. AYLPHIV require knowledge about their HIV status and empowerment with different skills including: self-advocacy skills, interpersonal skills, self-care skills, and HIV status disclosure skills, in order to assume responsibilities related to independent HIV care.

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Section: Introductionmentioning

confidence: 99%

A qualitative analysis of self-management needs of adolescents and young adults living with perinatally acquired HIV in rural, southwestern Uganda

Ashaba,

Baguma,

Tushemereirwe

et al. 2024

PLOS Glob Public Health

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A scoping review of qualitative studies on sexual and reproductive health and rights in Uganda: Exploring factors at multiple levels

Buser,

Kumakech,

August

et al. 2024

Womens Health (Lond Engl)

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Background: Uganda is burdened by high unintended and teen pregnancies, high sexually transmitted infections, and harm caused by unsafe abortion. Objectives: Explore factors influencing sexual and reproductive health and rights (SRHR) in Uganda by synthesizing evidence from qualitative studies using a scoping review. Eligibility Criteria: Original qualitative peer-reviewed research studies published between 2002 and 2023 in any language exploring factors influencing SRHR in Uganda. Sources of Evidence: Eight databases searched using qualitative/mixed methods search filters and no language limits. Charting Methods: Information extracted included author, article title, publication year, study aims, participant description, data collection type, sample size, main findings, factors at the individual, interpersonal, community, and policy levels, implications for SRHR in Uganda, and study limitations. Quality of the selected articles was assessed using the Critical Appraisal Skills Programme tool. Results: One hundred seventy-three studies met inclusion criteria. At the individual level, knowledge and attitudes toward SRHR, risky sexual behavior, and access to maternal SRHR services were identified as critical factors influencing health outcomes. Interpersonal factors included communication with sexual partners and relationships with family, school, and community members. Healthcare organization factors included adolescent access to education, SRHR services, and HIV prevention. Cultural and social factors included gendered norms and male involvement in SRHR. Policy-level factors included the importance of aligning policy and practice. Conclusions: Multiple factors at individual, interpersonal, community, healthcare, cultural, and policy levels were found to influence SRHR in Uganda. The findings suggest that interventions targeting multiple levels of the socio-ecological system may be necessary to improve SRHR outcomes. This review highlights the need for a holistic approach that considers the broader socio-ecological context. Reducing identified gaps in the literature, particularly between policy and practice related to SRHR, is urgently needed in Uganda. We hope this review will inform the development of policies and interventions to improve SRHR outcomes.

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Linking belief in a just world and psychological capital to psychological basic needs satisfaction and mental health of young adults living with HIV: A comparative analysis

Baluku,

Ouma,

Iredale

et al. 2024

PLOS Ment Health

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People living with HIV (PWH) have higher risks for negative experiences and emotions such as discrimination, self-blame, and denial, which make them vulnerable to mental health problems. Those living with HIV and are in the developmental stage of young adulthood (18–39 years) have added psychological challenges arising from the pressure to perform the developmental tasks of this stage, which may gratify or thwart basic psychological needs (BPNs) and impact their mental health. The study examined whether positive psychological attributes, including a belief in a just world (BJW) and psychological capital, could be resources for satisfying basic psychological needs, hence boosting the mental health of Young Adults Living with HIV (YALWH). A comparison sample of university students was also included in the study. The results show that BJW was positively directly associated with BPN satisfaction, BPN frustration, and mental health (flourishing aspect) in the student sample but not in the YALWH sample. Psychological capital was appositively associated with BPN satisfaction and flourishing in the student sample. On the other hand, psychological capital is only positively associated with BPN satisfaction and negatively with BPN frustration and distress in the YALWH sample. The serial medial analysis revealed that the effects of BJW on mental health (flourishing) are mediated by psychological capital and BPN satisfaction in both samples. On the other hand, the effects of BJW on distress are mediated by psychological capital and BPN frustration, again in both samples. Incorporating interventions for strengthening positive psychological attributes could be helpful for YALWH and other young adults to attain desirable developmental outcomes for this stage and their mental health.

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Challenges and Fears of Adolescents and Young Adults Living with HIV Facing Transition to Adult HIV Care

Cited by 4 publications

References 45 publications

A qualitative analysis of self-management needs of adolescents and young adults living with perinatally acquired HIV in rural, southwestern Uganda

A qualitative analysis of self-management needs of adolescents and young adults living with perinatally acquired HIV in rural, southwestern Uganda

A scoping review of qualitative studies on sexual and reproductive health and rights in Uganda: Exploring factors at multiple levels

Linking belief in a just world and psychological capital to psychological basic needs satisfaction and mental health of young adults living with HIV: A comparative analysis

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