Journal
PEDIATRIC INFECTIOUS DISEASE JOURNAL
Volume 36, Issue 3, Pages 311-313Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/INF.0000000000001392
Keywords
PEPFAR; transfer of HIV care; South Africa; pediatric; adolescent
Categories
Funding
- Health and Human Services
- Health Disparities Post Graduate Fellowship
- National Institute of Allergy and Infectious Disease [T32 AI 007433, K23 AI 068458, K24 AI062476, R01 AI058736]
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) [T32 HD 055148-02]
- Harvard University Center for AIDS Research [P30 AI060354]
- National Institute of Mental Health [R01 MH090326-03S1, R01 MH073445]
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HIV clinics formerly supported by the President's Emergency Plan for AIDS Relief are transferring patients to public-sector clinics. We evaluated adolescent linkage to care after a large-scale transfer from a President's Emergency Plan for AIDS Relief-subsidized pediatric HIV clinic in Durban, South Africa. All adolescents (11-18 years) in care at a pediatric statesubsidized, hospital-based clinic (HBC) were transferred, from May to June 2012, to government sites [primary health care (PHC) clinic; community health center (CHC); and HBCs] or private clinics. Caregivers were surveyed 7-8 months after transfer to assess their adolescents' linkage to care and their reports were validated by clinic record audits in a subset of randomly selected clinics. Of the 309 (91%) caregivers reached, only 5 (2%) reported that their adolescent did not link. Of the 304 adolescents who linked, 105 (35%) were referred to a PHC, 73 (24%) to a CHC and 106 (35%) to a HBC. A total of 146 (48%) linked adolescents attended a different clinic than that assigned. Thirty-five (20%) of the 178 who linked and were assigned to a PHC or CHC ultimately attended a HBC. Based on clinic validation, the estimated transfer success was 88% (95% confidence interval: 77%-97%). The large majority of adolescents successfully transferred to a new HIV clinic, although nearly half attended a clinic other than that assigned.
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