Barriers and Facilitators to the Successful Transition of Adolescents Living with HIV from Pediatric to Adult Care in Low and Middle-Income Countries: A Systematic Review and Policy Analysis

AbstractThe purpose of this  systematic review was twofold. First, we sought to summarize the literature on barriers and facilitators to successful healthcare transition for adolescents living with HIV from low- and middle-income countries (LMICs). Next, we assessed healthcare transition-related policies in countries fro m which we identified barriers and facilitators to determine the extent to which practice and policy meet to address the country-specific needs of adolescents living with HIV during healthcare transition. Ten studies met inclusion criteria. We identified four sub-themes of barriers to healthcare t ransition: emotional and psychological burden, effects of HIV disease, logistical and systemic impediments, and HIV stigma. We also identified five sub-themes of facilitators of healthcare transition: social support, skills development for adolescents and the adult treatment team, transition readi ness, multidisciplinary teams, and transition coordination. Of the 12 countries from which we identified barriers and facilitators to healthcare transition among adolescents living with HIV, only five (Uganda, Kenya, Thailand, Brazil, and Cambodia) had healthcare transition-specific guidelines. M oreover, there was substantial variation across country-specific guidelines regarding the existence of protocols to monitor and enforce guidelines, and whether there were allocated funds to assist healthcare clinics with implementation. Our review has led to severa...
Source: AIDS and Behavior - Category: Infectious Diseases Source Type: research