combine@alvar.ug

Ethical challenges of the healthcare transition to adult Antiretroviral therapy (ART) clinics for HIV infected adolescents and young people in Uganda

Ethical challenges of the healthcare transition to adult Antiretroviral therapy (ART) clinics for HIV infected adolescents and young people in Uganda

Show simple record

dc.contributor.author Mbalinda Sn
dc.contributor.author Bakeera-Kitaka S
dc.contributor.author Amooti Dl
dc.contributor.author Magongo En
dc.contributor.author Musoke P
dc.contributor.author Dan Kk
dc.date.accessioned 2021-01-11T13:51:41Z
dc.date.available 2021-01-11T13:51:41Z
dc.date.issued 2020
dc.identifier.uri https://combine.alvar.ug/handle/1/49451
dc.description.abstract Abstract; Introduction Many HIV infected adolescents require transfer of care from paediatric/ adolescent clinics to adult ART clinics. Transition is beset with factors that hinder or facilitate the process, thereby raising ethical challenges of the transition process. Decisions made regarding therapy, such as when and how to transition to adult HIV care, should consider ethical benefits and risks. Understanding and addressing ethical challenges in the healthcare transition could ensure a successful transition. The purpose of this study was to analyse the ethical challenges of transitioning HIV care for adolescents into adult HIV clinics. Method We conducted 18 focus group discussions among 191 adolescents attending 9 different health facilities in Uganda. We explored facilitators and barriers regarding adolescent transitioning to adult HIV clinics. Thematic data analysis was used to analyze the data. The Silences Framework guided the data analysis and interpretation. The principles of Bioethics and the four-boxes ethics framework for clinical care (Patient autonomy, Medical indications, Context of care and Quality of life) were used to analyze the ethical issues surrounding the transition to adult HIV care. Results The key emerging ethical issues were: reduced patient autonomy; increased risk of harm from stigma and loss of both privacy and confidentiality; unfriendly adult clinics induce disengagement and disruption of the care continuum; patient preference to transition as a cohort; and contextual factors are critical to successful transition. Conclusion The priority outcomes of the healthcare transition for adolescents should address ethical challenges of the healthcare transition to ensure retention in HIV care, facilitate long-term self-care, provide ongoing holistic healthcare and support in order to promote health and wellbeing, and build trust in the healthcare system. Identifying what facilitates successful transitions, and the gaps that interventions can target, may ensure HIV-infected youth remain healthy across the healthcare transition.
dc.publisher Research Square
dc.title Ethical challenges of the healthcare transition to adult Antiretroviral therapy (ART) clinics for HIV infected adolescents and young people in Uganda
dc.type Preprint
dc.identifier.doi 10.21203/rs.3.rs-32724/v1
dc.identifier.mag 3102991399
dc.identifier.lens 022-140-344-102-127
dc.subject.lens-fields Health care
dc.subject.lens-fields Antiretroviral therapy
dc.subject.lens-fields Hiv infected
dc.subject.lens-fields Family medicine
dc.subject.lens-fields Medicine


This record appears in the collections of the following institution(s)

Show simple record

Search Entire Database


Browse

My Account