Adolescent HIV Care and Treatment in Uganda: Care Models, Best Practices and Innovations to Improve Services

Abstract

Background: The number of adolescents living with HIV (ALHIV) in Uganda is growing. Improving access to HIV services among this population requires a lot of innovation. This study describes service delivery models and innovations to improve access to HIV care and treatment services by adolescents in Uganda. Methods: It was a mixed methods study in which the qualitative aspects included in-depth interviews, Focus Group Discussions and Key Informant Interviews with adolescents and various stakeholders. Quantitative data was obtained by a cross-sectional design using a questionnaire for 30 health facilities from 10 representative districts of Uganda. Results: The integrated HIV clinic model was used by 63% (19/30) of the facilities. The most preferred “Stand alone Adolescent HIV clinics” were present in only 17% (5/30). Separate adult and children’s HIV clinic models were 20% (6/30). Only 1/30 (3%) had a transition clinic. Health workers were ignorant about transition clinics but ALHIV expressed a great need for them. Only 30% (9/30) of the health facilities had Youth corners. “Peer support groups” were the commonest innovation present in 36% (9/25) of government facilities and 80% (4/5) of the private facilities. Other innovations included HIV testing at night, in schools, making community outreaches, avoiding clinic appointments during school time, use of social media, reducing waiting time, providing privacy, food, skills and transport among others. Conclusion: Stand-alone adolescent clinics are the preferred model of care for ALHIV. Youth corners in health facilities and peer support clubs were valued innovations but funding was a significant hindrance.