TB and TB-HIV care for adolescents and young adults.

TitleTB and TB-HIV care for adolescents and young adults.
Publication TypeJournal Article
Year of Publication2020
AuthorsEnane LA, Eby J, Arscott-Mills T, Argabright S, Caiphus C, Kgwaadira B, Steenhoff AP, Lowenthal ED
JournalInt J Tuberc Lung Dis
Volume24
Issue2
Pagination240-249
Date Published2020 Feb 01
ISSN1815-7920
Abstract

Nine high-burden public tuberculosis (TB) clinics in Gaborone, Botswana. To evaluate the challenges encountered, healthcare worker (HCW) approaches, and supported interventions in TB and TB-HIV (human immunodeficiency virus) care for adolescents and young adults (AYA, aged 10-24 years). Semi-structured interviews with HCW in TB clinics, analyzed using thematic analysis. Sixteen HCWs were interviewed. AYA developmental needs included reliance on family support for care, increasing autonomy, attending school or work, building trust in HCWs, and intensive TB education and adherence support. Stigma strongly influenced care engagement, including clinic attendance and HIV testing. Health system barriers to optimal AYA TB care included limited staffing and resources to follow-up or support. HCWs utilized intensive education and counseling, and transitioned AYA to community-based directly observed therapy whenever feasible. HCWs supported implementation of youth-friendly services, such as AYA-friendly spaces or clinic days, training in AYA care, use of mobile applications, and peer support interventions, in addition to health system strengthening. HCWs utilize dedicated approaches for AYA with TB, but have limited time and resources for optimal care. They identified several strategies likely to improve care and better retain AYAs in TB treatment. Further work is needed to study interventions to improve AYA TB care and outcomes.

DOI10.5588/ijtld.19.0416
Alternate JournalInt. J. Tuberc. Lung Dis.
PubMed ID32127110