Nwanja Esther, Akpan Uduak, Toyo Otoyo, Onwah Ogheneuzuazo, Ekwueme Chinazom, Dixon-Umo Ofonime, Gana Bala, Ndubueze Godson, Itanyi Ijeoma Uchenna, Ezeanolue Echezona, Idemudia Augustine, Igboelina Onyeka, Ogundehin Dolapo, James Ezekiel, Obiora-Okafo Chika, Asaolu Olugbenga, Onimode Bayo, Katbi Moses, Pius Jemeh, Oyelaran Omosalewa, Onyedinachi Okezie, Adegboye Adeoye, Eyo Andy
Excellence Community Education Welfare Scheme, Uyo, Nigeria.
Center for Translation and Implementation Research, College of Medicine, University of Nigeria, Enugu, Nigeria.
PLoS One. 2025 May 12;20(5):e0321962. doi: 10.1371/journal.pone.0321962. eCollection 2025.
In October 2019, a peer-based transition preparedness model was introduced as part of peer club activities to prepare young persons living with HIV (YLHIV) for adult care. This study compared the 12 and 24 months treatment outcomes of YLHIV who transitioned to adult care in primary, secondary and tertiary health facilities in Southern Nigeria, following the introduction of this model.
This was a retrospective cohort study using data extracted from the medical records of YLHIV who transitioned to adult care at 25 years in 2018 and in 2021 across 155 healthcare facilities in southern Nigeria. Baseline data at transition, as well as 12 and 24 months post-transition data were extracted for comparison between those who were transitioned before (2018 cohort) and after (2021 cohort) the transition preparedness model was introduced. Logistics regression analysis was used to compare client continuity on treatment and undetectable viral load between the two groups at 12 and 24 months after transitioning to adult care.
Most of the1,555 YLHIV who transitioned to adult care in 2018 (n = 343, 22.1%) and 2021 (n = 1,212, 77.9%) were females (91.0% in 2018 v.82.6% in 2021) and initiated ART at 20 years or older (92.7% v. 95.7%). A higher proportion of those in the 2021 cohort were continuously retained both at 12 months and 24 months post-transitioning compared to those in the 2018 cohort (12 months: 96.7% vs 80.2%, p < 0.001; 24 months: 92.7% vs 77.6% p < 0.001). Similarly, the proportion of YLHIV with undetectable viral load in the 2021 cohort was significantly higher than those in the 2018 cohort at both 12 months (96.1% vs 60.1%, p < 0.001) and 24 months (93.3% vs 80.6%, p < 0.001), respectively.
Peer-based transition preparedness model improved treatment outcomes of YLHIV who transition to adult care. Programs should implement tailored, peer-based interventions to address gaps in service delivery.
2019年10月，一种基于同伴的过渡准备模型作为同伴俱乐部活动的一部分被引入，旨在帮助感染艾滋病毒的年轻人（YLHIV）为成人护理做好准备。本研究比较了在尼日利亚南部引入该模型后，在初级、二级和三级卫生设施中转至成人护理的YLHIV在12个月和24个月时的治疗结果。
这是一项回顾性队列研究，使用从2018年和2021年在尼日利亚南部155家医疗机构中转至成人护理的YLHIV的医疗记录中提取的数据。提取过渡时的基线数据以及过渡后12个月和24个月的数据，以比较在引入过渡准备模型之前（2018队列）和之后（2021队列）过渡的患者之间的情况。使用逻辑回归分析比较两组在转至成人护理后12个月和24个月时的治疗连续性和病毒载量检测不到的情况。
2018年（n = 343，22.1%）和2021年（n = 1,212，77.9%）转至成人护理的1,555名YLHIV中，大多数为女性（2018年为91.0%，2021年为82.6%），并在20岁及以上开始接受抗逆转录病毒治疗（ART）（92.7%对95.7%）。与2018队列中的患者相比，2021队列中的患者在过渡后12个月和24个月时持续接受治疗的比例更高（12个月：96.7%对80.2%，p < 0.001；24个月：92.7%对77.6%，p < 0.001）。同样，2021队列中病毒载量检测不到的YLHIV比例在12个月（96.1%对60.1%，p < 0.001）和24个月（93.3%对80.6%，p < 0.001）时均显著高于2018队列。
基于同伴的过渡准备模型改善了转至成人护理的YLHIV的治疗结果。项目应实施量身定制的、基于同伴的干预措施，以解决服务提供方面的差距。
