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. 2025 May 6;10(5):126. doi: 10.3390/tropicalmed10050126.
Adolescents living with HIV (ALHIV) (10-19 years) make up approximately 4.2% (320,000) of people living with HIV in South Africa. Adolescence is a developmental period characterized by pervasive biological, social and psychological changes, which challenges adherence and retention in care for ALHIV on antiretroviral therapy (ART). Further, as ALHIV grow "older", they are expected to transition to the adult HIV treatment programme, where they should assume greater responsibility for managing their chronic condition and healthcare pathway. Whereas it is imperative that ALHIV are transitioned when they are ready, little is known about the challenges and experiences of ALHIV before and during transition. The aim of this paper was to report on the experiences and challenges of transition for ALHIV who received ART at an adolescent-friendly service that is adjunct to a public primary healthcare facility in the Western Cape province of South Africa.
Photovoice methods were employed to explore the transition experiences of ALHIV on ART at a "supportive transition" public health facility in the Cape Town Metro in South Africa. Participants took pictures that depict their experience pre- and during transition to adult care and discussed these in groups with peers. Audio data were digitally recorded and transcribed verbatim and subjected to thematic analysis using Atlas.Ti version 24.
The emergent themes described their apprehension to transitioning to adult care; self-management; challenges to adherence; the need for psychosocial support; and how adolescent-friendly services were filling the gap.
We illuminate the "I-We-I" configuration, to reflect (the first "I") individual ALHIV experiences as isolated before being transferred to the supportive facility; how they experience a sense of belonging and family ("we") in the supportive facility; but face apprehension about transitioning to adult care in the local clinic, where they have to self-manage (final "I").
感染艾滋病毒的青少年（10至19岁）约占南非艾滋病毒感染者的4.2%（32万）。青春期是一个发育阶段，其特点是生物、社会和心理发生广泛变化，这对感染艾滋病毒的青少年坚持接受抗逆转录病毒治疗（ART）并持续留在护理体系中构成挑战。此外，随着感染艾滋病毒的青少年逐渐“长大”，他们预计将过渡到成人艾滋病毒治疗项目，在该项目中，他们应承担起更多管理自身慢性病和医疗保健途径的责任。虽然当感染艾滋病毒的青少年准备好时进行过渡至关重要，但对于他们在过渡前和过渡期间所面临的挑战和经历却知之甚少。本文的目的是报告在南非西开普省一家附属于公共初级医疗保健机构的青少年友好型服务机构接受抗逆转录病毒治疗的感染艾滋病毒的青少年的过渡经历和挑战。
采用摄影声音方法，在南非开普敦市地铁区一家“支持性过渡”公共卫生机构，探索接受抗逆转录病毒治疗的感染艾滋病毒的青少年的过渡经历。参与者拍摄描绘他们在向成人护理过渡前和过渡期间经历的照片，并与同龄人分组讨论这些照片。音频数据进行数字记录并逐字转录，使用Atlas.Ti 24版本进行主题分析。
浮现出的主题描述了他们对过渡到成人护理的担忧；自我管理；坚持治疗的挑战；对心理社会支持的需求；以及青少年友好型服务如何填补空白。
我们阐明了“I - 我们 - I”结构，以反映（第一个“I”）感染艾滋病毒的青少年个体在被转移到支持性机构之前的孤立经历；他们在支持性机构中如何体验归属感和家庭感（“我们”）；但在当地诊所过渡到成人护理时面临担忧，在那里他们必须自我管理（最后的“I”）。
