Social and clinical outcomes of adolescents and young adults with HIV transitioned from pediatric to adult-centered care at the university teaching hospital of Kigali (CHUK)

Abstract

B ackground: HIV is a health burden globally. With the introduction of HAART, many HIV- infected children are surviving up to adulthood, necessitating transition from pediatric to adult care.

Aim: The purpose of this study was to determine the social and clinical outcomes of HIV-infected adolescents and young adults (YA) transitioned from pediatric to adult care at CHUK.

Me thods : We did a cross-sectional study at CHUK. We targeted HIV-infected adolescents and YA transitioned from pediatric to adult HIV clinic from January 2016 to December 2019. We used descriptive statistics to characterize the study population and paired T-test to compare pre-and post-transition viral loads.

Re s ults : During the study period, 85 adolescents and YA were transitioned from pediatric to adult

HIV clinic at CHUK. Among them, 57 consented to the study.

At the time of transition, The median age was 19. More than half (56.1%) of participants were male, and 43.9% were female. Most of them (82.4%) were still having at least one parent alive. Seventy-seven percent were still in a school setting, more than half (61.4%) had no job and only 14% had no health insurance.

More than half of the youth (69.6%) confirmed that they were sexually active. Among females, only 8% stated that they had ever been pregnant. Only 8.8% of the participants confirmed that they had become parents, 7% stated that they had STI (s) other than HIV since the time of transition and 15.8% stated that they had opportunistic infection (s) since the time of transition.

At 3 years post-transition, the VL suppression had increased from 82.5% to 94.7% and the mean VL had decreased from 4454.3 to 3867.9. The difference in means of viral loads was not prove n to be statistically significant. The majority of our population (96.5%) were still engaged in care.

Conclus ion: The high rate of retention in care among our participants is likely due to the emphasis of the government of Rwanda on HIV prevention and management. More work is needed to determine the post-transition outcomes of HIV-infected adolescents and YA at a national level.