Exploring lived experiences of adolescents who have transitioned to adulthood care at Lighthouse clinic in Lilongwe, Malawi: A qualitative study

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Date
2022-03-11
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Kamuzu University of Health Sciences
Abstract
Type of research study This is a phenomenological study that will focus on exploring lived experiences of young adults who have transitioned to adulthood care after being managed through ART adolescents’ clinics. Problem In most ART clinical settings in Africa, ART clinics manage adults and adolescents separately with the aim of meeting their ART needs as well as improving clinical ART outcomes for both populations. Adolescents are young people aged 10–19 years, undergoing rapid psychological, sexual, and physical maturity. Adolescents living with HIV have largely been associated with poor retention in care as such, they have been managed largely through pediatric/adolescent clinics, and with great support from their parents as well as guardians. They have adolescent days with specific health workers who provide the adolescent ART services. Once adolescents reach 19 years and are stable on ART, they are transitioned to adulthood care so that they can manage ART clinic on their own. Studies of young people who are on ART show that they face numerous barriers to adherence compared with adults, they have lower rates of viral suppression and higher rates of virology rebound and loss to follow up. ART outcomes of ages 20-24 have low retention rates. High proportion of this group include adolescents who have graduated or transition to adulthood care. There is need, therefore, to establish and understand the lived experiences of adolescents that have transitioned to adulthood care to come up with interventions that will improve their overall retention outcomes. Objectives Broad objective To explore lived experiences regarding ART uptake among adolescents who have transitioned to adulthood ART care at Lighthouse clinic in Lilongwe. Specific objectives 1. To assess individual and health system factors that affect ART service uptake among adolescents. 2. To assess the adolescent’s perceptions of adulthood care 6 months after transitioning. 3. To explore barriers and enablers of ART uptake among adolescents who have graduated into adulthood care from ART providers and parents/guardians 11-Mar-2022 Odala__Version 2.0 dated 20220112 9 Methodology The study will use a phenomenological design as the focus will be to explore the lived experiences of adolescents who have transitioned to adulthood care. The study will be conducted at Martin Preuss Centre (MPC) where adolescent services are provided. The study population will be adolescents who were accessing care at Martin Preuss Centre (MPC) and have transitioned to adulthood ART care 6 months’ post transitioning to adulthood care. Guardians/parents and health care workers providing ART care to the adolescents who have transitioned to adulthood care will also be part of the study. Expected findings and their dissemination. The study expects to find the experiences of young adults after transitioning to adulthood care, the challenges as well as success of ART post transitioning. The findings of the study will be shared with will the implementing organisation, Lighthouse Trust, the relevant government authorities (Ministry of Health), and the Centre for Disease Control (CDC) in Malawi.
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