Social and Behavioral Sciences Commons^™

Community-Based Accompaniment For Adolescents Transitioning To Adult Hiv Care In Urban Peru: A Pilot Study, Valentina Vargas, Milagros Wong, Carly A. Rodriguez, Hugo Sanchez, Jerome T. Galea, Alicia Ramos, Liz Senador, Lenka Kolevic, Eduardo Matos, Eduardo Sanchez, Renato A. Errea, Karen Ramos, Catherine Beckhorn, Andrew Lindeborg, Carlos Benites, Leonid Lecca, Sonya Shin, Molly F. Franke

Social Work Faculty Publications

We piloted a community-based intervention to improve outcomes among adolescents living with HIV who were transitioning to adult-oriented care in Lima, Peru. We assessed feasibility and potential effectiveness, including within-person changes in self-reported adherence, psychosocial metrics (NIH Toolbox), and transition readiness (“Am I on TRAC” questionnaire, “Got Transition” checklist). From October 2019 to January 2020, we enrolled 30 adolescents (15–21 years). The nine-month intervention consisted of logistical, adherence and social support delivered by entry-level health workers and group sessions to improve health-related knowledge and skills and social support. In transition readiness, we observed within-person improvements relative to baseline. We also …

Patient And Provider Perceptions Of A Community-Based Accompaniment Intervention For Adolescents Transitioning To Adult Hiv Care In Urban Peru: A Qualitative Analysis, Jerome T. Galea, Milagros Wong, Brennan Ninesling, Alicia Ramos, Liz Senador, Hugo Sanchez, Lenka Kolevic, Eduardo Matos, Eduardo Sanchez, Renato A. Errea, Andrew Lindeborg, Carlos Benites, Leonid Lecca, Sonya Shin, Molly F. Franke

Social Work Faculty Publications

Introduction: Adolescents living with HIV (ALWH) experience higher mortality rates compared to other age groups, exacerbated by the suboptimal transition from paediatric to adult HIV care, during which decreased adherence to antiretroviral therapy (ART) and unsuppressed viremia are frequent. Care transition—a process lasting months or years—ideally prepares ALWH for adult care and can be improved by interventions that are youth-friendly and address psychosocial issues affecting ART adherence; however, such interventions are infrequently operationalized. Community-based accompaniment (CBA), in which laypeople provide individualized support and health system navigation, can improve health outcomes among adults with HIV. Here, we describe patient and provider …

A Non-Specialist Depression Care Pathway For Adolescents Living With Hiv And Transitioning Into Adult Care In Peru: A Nested, Proof Of Concept Pilot Study, Jerome T. Galea, Carmen Contreras, Milagros Wong, Karen Ramos, Valentina Vargas, Hugo Sánchez, Renato A. Errea, Leonid Lecca, Molly F. Franke

Social Work Faculty Publications

Background: Adolescents living with HIV (ALWH) are disproportionally impacted by depression, experiencing worse HIV outcomes. Integrated depression and HIV care may support antiretroviral adherence. This study pilot tested for proof of concept a basic depression care pathway for ALWH to inform depression care integration with HIV services in Peru.

Methods: ALWH were screened for depression with the Patient Health Questionnaire-9 (PHQ-9). Participants with PHQ-9 scores of ⩾10 or suicidal ideation (SI) were eligible for Psychological First Aid (PFA) delivered by non-mental health specialists. Participants with PHQ-9 re-assessments of ⩾20 or SI were referred to specialized services.

Results: Twenty-eight (11 female, …