Abstract
BackgroundThe Human Immunodeficiency Virus (HIV) epidemic is growing rapidly among South African adolescents and young adults (AYA). Although HIV counselling and testing, HIV prevention and treatment options are widely available, many AYA delay health-seeking until illness occurs, demonstrating a need for youth responsive, integrated sexual and reproductive health services (SRHS). While feasibility and cost-effectiveness have been evaluated, acceptability of mobile clinics among AYA has yet to be established. The objective of this study was to investigate patient acceptability of mobile AYA SRHS and compare mobile clinic usage and HIV outcomes with nearby conventional clinics.MethodsPatients presenting to a mobile clinic in Cape Town were invited to participate in an acceptability study of a mobile clinic after using the service. A trained researcher administered an acceptability questionnaire. Mobile clinic medical records during the study period were compared with the records of AYA attending four clinics in the same community.ResultsThree hundred three enrolled participants (16–24 years, 246 (81.2%) female) rated mobile AYA SRHS acceptability highly (median = 4,6 out of 5), with 90% rating their experience as better or much better than conventional clinics. The mobile clinic, compared to conventional clinics, attracted more men (26% v 13%, p < 0,000), younger patients (18 v 19 years, p < 0,000), and yielded more HIV diagnoses (4% v 2%, p < 0,000).ConclusionsGiven the high ratings of acceptability, and the preference for mobile clinics over conventional primary health clinics, the scalability of mobile clinics should be investigated as part of a multipronged approach to improve the uptake of SRHS diagnostic, prevention and treatment options for AYA.
Highlights
The Human Immunodeficiency Virus (HIV) epidemic is growing rapidly among South African adolescents and young adults (AYA)
Half (n = 150, 50%) of the participants lived in informal housing and most (93%) had previously tested for HIV
The length of time it took to be seen at a conventional clinic facility was the most often cited (47%, Table 1 Participant demographics and bivariate regressions for acceptability of the mobile clinic n (%)
Summary
The Human Immunodeficiency Virus (HIV) epidemic is growing rapidly among South African adolescents and young adults (AYA). In combination with biochemical prevention methods, such as pre-exposure prophylaxis (PrEP), access to ART programs can significantly curb the HIV epidemic Attaining this ambitious goal requires innovation that links young South Africans to SRHS, including diagnosis, prevention, treatment, adherence and viral suppression [1, 26,27,28,29]. With this in mind, youthfriendly services have been recommended for AYA [6, 30,31,32]. Youth-friendly services typically have been designed for youth, or are conventional health facilities that have been adapted to serve AYA by providing tailored information and care that is appropriate to the developmental stage [34]
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