Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
Lancet HIV. 2022 Oct;9(10):e726-e734. doi: 10.1016/S2352-3018(22)00137-0. Epub 2022 Sep 8.
Adolescents and young people living with HIV are at risk of disengaging from HIV care at all stages of the care cascade. Differentiated models of care offer simplified HIV-service delivery options in the hope of improving treatment outcomes, including retention on antiretroviral therapy. However, it remains unclear how successful and widespread these models are for adolescents in sub-Saharan Africa, where the burden of HIV is the greatest. Very few differentiated models of care specifically targeted to adolescents can be found and this priority group are currently ineligible from several models that exist. Where differentiated care has been made available to adolescents, data on the implementation and effectiveness of these interventions remain scarce. Despite this scarcity of evidence on the effectiveness of differentiated care among adolescent populations, several interventions, particularly community-based groups with peer navigators or supporters, might have potential to increase the reach, effectiveness, and adoption of differentiated care in adolescent HIV-care programmes.
青少年和青年艾滋病毒感染者在整个护理级联的各个阶段都面临着脱离艾滋病毒护理的风险。差异化的护理模式提供了简化的艾滋病毒服务提供选择，以期改善治疗结果，包括抗逆转录病毒治疗的保留率。然而，在艾滋病毒负担最大的撒哈拉以南非洲地区，这些模式对青少年的成功和普及程度尚不清楚。几乎找不到专门针对青少年的差异化护理模式，而且目前有几个现有的模式不适用于这一优先群体。在为青少年提供差异化护理的地方，关于这些干预措施的实施和效果的数据仍然很少。尽管关于青少年人群中差异化护理效果的证据稀缺，但一些干预措施，特别是具有同伴导航员或支持者的基于社区的团体，可能有潜力增加差异化护理在青少年艾滋病毒护理方案中的覆盖范围、效果和采用。
