Kganya Motsha Adolescent Centre: a model for adolescent friendly HIV management and reproductive health for adolescents in Soweto, South Africa

Abstract

This paper reports on Kganya Motsha Adolescent Centre, an adolescent program specifically established to provide voluntary counseling and testing as well as management of HIV-positive young people in Soweto, South Africa. A retrospective cross-sectional analysis, using clinic records of young people accessing services from 2008 to 2012, was conducted. Of the 11,522 who tested, 7689 (67%) were females. The total number of HIV infections was 410, with an HIV prevalence of 3.6% (95% CI 3.2-3.9%). More females (332, 4% vs. 72, 2%; p < 0.0001) were HIV-infected than males. Of those testing HIV positive, 109 (26.5%) had a median CD4 cell count of 491 (IQR 345-686) cells/mm(3). Only 12/410 individuals (2.9%) were eligible for antiretroviral treatment and 10 (2.4%) of those successfully received treatment. The program observed that young people testing HIV positive would not return for follow up blood specimens or confirmatory results. Future programs should consider innovative ways of retaining adolescents in care to reduce potential HIV transmissions that could lead to deteriorating health.

Prevalence, type, and correlates of trauma exposure among adolescent men and women in Soweto, South Africa: implications for HIV prevention

“…Soweto is a large township southwest of Johannesburg with a population of approximately 1.3 million predominantly (98.5%) black inhabitants residing in informal and formal settlements [32]. While there are no population-level statistics on HIV prevalence among adolescents in Soweto, a recent study of 11,552 adolescents and young adults (14–25 years) residing in Soweto, reported that 4% of those who accessed HIV testing services at a local youth-centered clinic tested positive for HIV, including 2% of young men 4% of young women [33]. …”

“…KMAC was opened in 2008 with a local mandate to address HIV and sexual and reproductive health priorities of adolescents (ages 14–19 years). Earlier pilot studies on adolescent health identified the urgent need for such youth-centred services, and informed the development and implementation of BBAHS [33–36]. …”

Optimizing linkage to care and initiation and retention on treatment of adolescents with newly diagnosed HIV infection

“…Loss to follow-up during the period between positive HIV testing and linkage to care, delayed initiation of antiretroviral therapy (ART), and poor levels of early retention in care significantly contribute to high HIV-related morbidity and mortality globally among adolescents and youth [8,10–14]. Addressing these challenges is particularly important during the initial stage following a new diagnosis of HIV in adolescents and youth, a time when successful initiation into the HIV care cascade may improve long-term outcomes and decrease HIV transmission among these key populations.…”

Seeking wider access to HIV testing for adolescents in sub-Saharan Africa

“…While advocating for and strengthening HTC uptake and coverage, linkage to quality care should be available to make HTC ultimately beneficial. Recent studies have cited early loss-to-follow-up, refusal of care, and nonreceipt of baseline CD4 as barriers to engagement in care among newly-identified ALHIV (68)(69)(70). We recommend the following measures to create an enabling environment for HTC among adolescents, including those at highest risk:…”