150. On TRACK to Transition: Designing a Transition Readiness Assessment Checklist and model for young adults living with HIV at the University Teaching Hospital of Kigali
Session: Poster Abstract Session: Big Viruses in Little People (Pediatric Viral Diseases)
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • IDWEEK POSTER 2016.pdf (608.7 kB)
  • Background: In Sub-Saharan Africa HIV-infected children are increasingly surviving into adulthood, creating the need to transition them from pediatric clinics into adult care. There are currently no transition protocols in any pediatric HIV clinics in Rwanda. This study aimed to assess transition readiness of HIV-infected young adults attending a pediatric HIV clinic and develop a transition protocol.

    Methods: This was qualitative study of HIV–infected patients aged ≥ 20 years in the University Teaching Hospital of Kigali pediatric HIV clinic, and their healthcare providers (HCPs). Individual 20-minute open-ended interviews were conducted in Kinyarwanda, audio taped, then transcribed. The grounded theory approach was used for analysis; transcripts were coded, and then grouped into concepts.

    Results: Ten HIV-infected patients and four HCPs were interviewed. The mean age of the patients was 21 years (range 20-24).Four major categories of themes were identified from interview responses (Table 1). Based on the responses we identified areas that HCPs need to focus on and developed a transition checklist and model to be used in the HIV clinic.

    Conclusion: The perceived readiness to transition care among the young adults was low. Though the patients had autonomy in their healthcare management, there were knowledge gaps about disease and drug regimen. In addition, HCPs expressed discomfort in caring for young adults and could benefit from additional training in adolescent medicine. In the next steps of this project, the transition checklist and protocol will be implemented and the patients will be followed for outcomes

    Table 1. Major themes identified from interviews in a pediatric HIV clinic about transition to adult care.

    Major categories

    Subcategories

     

    Self-management behaviors

    • Knowledge of disease
    • Knowledge of drug regimen, dosages and side effects

    Readiness to assume responsibility

    • Responsibility in management of clinical condition
    • Participation in treatment management
    • Involvement in high-risk behaviors

     

    Barriers to transition

    • Fear of loss of relationship with pediatric HCPs
    • Fear of new environment
    • Fear of stigmatization in adult clinic

     

    Transition readiness

    • Create transition clinic
    • Visit adult clinic prior to transition
    • Perceived transition readiness

    Febronie Mushimiyimana, MBChB, Pediatrics, University of Rwanda, Kigali, Rwanda, Lisine Tuyisenge, MBChB, MMed, Pediatrics, University Teaching Hospital of Kigali, Kigali, Rwanda, Brenda Kateera-Asiimwe, MD, MPH, University of Rwanda, Kigali, Rwanda and Tanya Rogo, MD, Pediatrics, Brown University Alpert Medical School, Providence, RI

    Disclosures:

    F. Mushimiyimana, None

    L. Tuyisenge, None

    B. Kateera-Asiimwe, None

    T. Rogo, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.