Download Free Medical High Retention and Viral Suppression Rates Among HIV-infected Adolescents Attending an Adolescent- friendly Clinic in South Africa PowerPoint Presentation

High Retention and Viral Suppression Rates Among HIV-infected Adolescents Attending an Adolescent- friendly Clinic in South Africa PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : High Retention and Viral Suppression Rates Among HIV-infected Adolescents Attending an Adolescent- friendly Clinic in South Africa

Tags : Pediatrics, Child Health, pediatric practice, pediatrician, health providers, HIV-infected infants, Adolescent Transition, HIV-infected adolescents, epidemiology, south africa

Published on : Jul 16, 2020 | Views : 1503 | Downloads : 0

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

High Retention and Viral Suppression Rates Among HIV-infected Adolescents Attending an Adolescent- friendly Clinic in South Africa Brian Zanoni MD, MPH; Challine Cairns MBCh; Thobekile Sibaya; Sara Lammert MS; Jessica Haberer MD, MSc
Slide 2-

South African HIV-infected Adolescents Estimated 870,000 infected adolescents and young adults in 2013 ages 15 to 24 Behaviorally infected Perinatally infected
Slide 3-

Approaching Wave of Perinatally HIV- infected Adolescents in South Africa 150,000 200,000 250,000 300,000 350,000 0 20,000 40,000 60,000 80,000 100,000 120,000 400,000 HIV Infections in Children Ages 0-14 Years Perinatally HIV-infected Infants 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Incidence of HIV-infected Infants Prevalence of HIV-infected Children 0 to 14 Years
Slide 4-

Hypotheses Adolescents attending a dedicated adolescent clinic have higher retention in care compared to those attending the standard pediatric clinic Adolescents attending a dedicated adolescent clinic have higher viral suppression compared to those attending the standard pediatric clinic
Slide 5-

Study Design Cross-sectional, retrospective analysis Perinatally HIV-infected adolescents and young adults ages 13 to 24 Attending Don McKenzie Hospital’s HIV clinic in Botha’s Hill, South Africa
Slide 6-

Durban Pietermaritzburg Don McKenzie Hospital KwaZulu-Natal Province South Africa Durba n
Slide 7-

Setting
Slide 8-

Methods Records from April 2007 to November 2015 Demographic information Clinical data Laboratory data Tracking Patients not in care  no refill or visit in 3 months Contacted by clinic staff via phone Home visit by clinic staff Searched national laboratory database for recent labs
Slide 9-

Study Population Inclusion criteria Attending Don McKenzie Hospital’s clinic Standard Clinic (n=153) Adolescent Clinic (n=88) Ages 13 to 24 years Perinatally HIV-infected Receiving antiretroviral therapy
Slide 10-

Adolescent Clinic Enrollment Adult Clinic Standard Clinic Initiate ART 6 months ART Stable weight After March 2009 Adolescent Clinic Capacity 80 Filled 2012 Transportation Disinterest Schedule conflicts
Slide 11-

Standard vs. Adolescent Clinic
Slide 12-

Outcome Definitions Retention in care Medication refilled in last 3 months Transfers Considered retained if had active prescription within 3 months of documented transfer Viral suppression Viral load <400 copies/ml at most recent results Retained and suppressed Clinic visit, pharmacy refill and viral load <400 copies/ml within the last 12 months
Slide 13-

Tracking Results 254 initiated ART 189 active Not in care at Don McKenzie 5 deaths 29 transfers 18 lost to follow-up 11 alternate site 4 defaulted therapy 3 unknown 13 initiated as inpatients and transferred at discharge
Slide 14-

Demographics
Slide 15-

Overall Outcomes Retention 89% (214/241) Viral suppression 84% (196/233)
Slide 16-

Higher Retention and Viral Suppression with Adolescent Clinic
Slide 17-

Higher Retention in Adolescent Clinic
Slide 18-

Higher Viral Suppression in Adolescent Clinic
Slide 19-

Retained with Viral Suppression in last 12 Months Tracked all 241 patients for viral load results in last 12 months 73% retained and suppressed Standard clinic (64%) Adolescent clinic (90%) Adolescent clinic attendance Adjusted OR 8.4; p<0.001
Slide 20-

Sensitivity Analysis Excluding all subjects (n=3) lost in the first 6 months of therapy o Would not have been eligible for adolescent clinic No change in results for retention, viral suppression or combined retention with viral suppression No difference when adjusting for propensity score
Slide 21-

Limitations Retrospective analysis Not randomized Survival bias
Slide 22-

Next Steps Qualitative analysis Interviews with adolescents in adolescent clinic Interviews with adolescents in standard clinic Interviews with adolescents not in care Interviews with care givers
Slide 23-

Acknowledgements Jessica Haberer David Bangsberg Ken Mayer Bisola Ojikutu Sara Lammert South Africa USA Stephen Carpenter Tappie Cairns Nokuthula Buthulezi Thobekile Sibaya Patients and Staff at Don McKenzie Hospital Funding: NIH T32 NAID AI 007433
Slide 24-

Questions

User Presentation
Related Presentations

Pediatric Drug Shortage Trends Best Practices Mitigation Strategies

By: MarieAltmann
Views: 2176

Changing Diabetes in Children - diagnosis, treatment and organizing of diabetes care for children

By: MarieAltmann
Views: 2025

Overview of Paediatric HIV Treatment and Prevention

By: MarieAltmann
Views: 1674

Neonatal and paediatric immunology relevant to HIV persistence

By: MarieAltmann
Views: 1463

The global epidemiology of perinatally HIV-infected adolescents

By: MarieAltmann
Views: 1396

Pediatric Pharmacology - Antibiotics

By: drdwayn
Views: 1473

Neonatal Hypoglycemia And Hypocalcemia

By: medhelp
Views: 1396

Primary Care of The Preterm Infant

By: medhelp
Views: 969

Respiratory Distress in Newborn

By: yourdoctors
Views: 1377

Skenario Gnaps

By: wira0511gmail.com
Views: 1366

MarieAltmann

About : I am a passionate Pediatrician with experience of working in world-renowned hospital systems as well as community-based clinics. I have skills like Advocacy, Team Building, Event Planning, and Public Speaking. A dedicated and worthy healthcare services professional with a MPH focused in International studies from Tulane School of Public Health and Tropical Medicine.
Occupation : Medical Professional
Specialty : MD
Country : United States of America
Website :

HEALTH A TO Z