Petinger Charné, van Wyk Brian, Crowley Talitha
School of Public Health, University of the Western Cape, Cape Town 7535, South Africa.
School of Nursing, University of the Western Cape, Cape Town 7535, South Africa.
Trop Med Infect Dis. 2024 Dec 24;10(1):5. doi: 10.3390/tropicalmed10010005.
(1) Background: Globally, an estimated 1.7 million adolescents (aged 10-19 years) were living with HIV in 2023, with 82% residing in sub-Saharan Africa. For ALHIV, transitioning to adult care involves assuming responsibility for their own health and disease management, posing significant challenges to persistent engagement in care. There is a paucity in health policies guiding this transition in many sub-Saharan African countries. Overburdened and poorly functioning health systems struggle to provide optimal care for ALHIV amidst the rising HIV pandemic in this priority population. (2) Methods: This study employed a mixed-methods design, comprising a descriptive qualitative study with healthcare workers and managers and a cross-sectional survey to examine the practices and pathways in which the transition to adult HIV care occurs in the Cape Town Metropole, South Africa. (3) Results: We delineate three distinct ways in which transition occurs (transfer-only, adolescent-friendly, and supportive transition). A successful transition involves a sufficient level of self-management of their chronic condition and healthcare journey, which is preceded by adequate preparation pre-transition, and the monitoring of engagement post-transition. This ideally requires developing relevant health policies and implementing guidelines signaling political will and providing the impetus and agency of implementation at the service level in South Africa.
(1) 背景：2023年，全球估计有170万青少年（10 - 19岁）感染艾滋病毒，其中82%居住在撒哈拉以南非洲。对于青少年和儿童期感染艾滋病毒者（ALHIV）而言，向成人护理过渡意味着要对自身健康和疾病管理负责，这给持续接受护理带来了重大挑战。在许多撒哈拉以南非洲国家，指导这一过渡的卫生政策匮乏。在这一重点人群中，艾滋病毒疫情不断上升，负担过重且运转不良的卫生系统难以向青少年和儿童期感染艾滋病毒者提供最佳护理。(2) 方法：本研究采用混合方法设计，包括对医护人员和管理人员进行描述性定性研究以及开展横断面调查，以研究南非开普敦都会区向成人艾滋病毒护理过渡的做法和途径。(3) 结果：我们描述了过渡发生的三种不同方式（仅转诊、青少年友好型和支持性过渡）。成功的过渡需要他们对自身慢性病状况和医疗过程有足够的自我管理水平，在此之前要有充分的过渡前准备，以及过渡后对参与情况的监测。理想情况下，这需要制定相关卫生政策并实施指导方针，以表明政治意愿，并在南非的服务层面提供实施的动力和机构支持。
