ArticlePloS one2014
From transmission to transition: lessons learnt from the Thai paediatric antiretroviral programme.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Prevention of mother-to-child HIV transmission cascade in China: a systematic review and meta-analysis.Sexually transmitted infections · 2016Pooled it
- Article
- High mortality in adolescents and young adults with perinatally-acquired HIV in Thailand during the transition to adulthood.AIDS care · 2024Article
- Letting go/ moving on: A scoping review of relational effects on transition to adult care.Health care transitions · 2024Article
- Alcohol use, suicidality and virologic non-suppression among young adults with perinatally acquired HIV in Thailand: a cross-sectional study.Journal of the International AIDS Society · 2023Article
- A focused multi-state model to estimate the pediatric and adolescent HIV epidemic in Thailand, 2005-2025.PloS one · 2022Article
- "Because we all have to grow up": supporting adolescents in Uganda to develop core competencies to transition towards managing their HIV more independently.Journal of the International AIDS Society · 2020Article
- Longitudinal evaluation of adherence, retention, and transition patterns of adolescents living with HIV in Nigeria.PloS one · 2020Article
- Mental health challenges among adolescents living with HIV.Journal of the International AIDS Society · 2017Review
- HIV treatment and care services for adolescents: a situational analysis of 218 facilities in 23 sub-Saharan African countries.Journal of the International AIDS Society · 2017Article
- Adolescents with HIV and transition to adult care in the Caribbean, Central America and South America, Eastern Europe and Asia and Pacific regions.Journal of the International AIDS Society · 2017Article
- A review of transition experiences in perinatally and behaviourally acquired HIV-1 infection; same, same but different?Journal of the International AIDS Society · 2017Review
- Factors influencing antiretroviral treatment suboptimal adherence among perinatally HIV-infected adolescents in Thailand.PloS one · 2017Article
- Getting to 90-90-90 in paediatric HIV: What is needed?Journal of the International AIDS Society · 2015Article
- Achieving 90-90-90 in paediatric HIV: adolescence as the touchstone for transition success.Journal of the International AIDS Society · 2015Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Thai HIV programme is a leader in the public health approach to HIV treatment. Starting at transmission of HIV and ending with transition to adult services this paper assesses the paediatric HIV treatment continuum from three perspectives: service-user, provider and policy maker, to understand what works well and why.
methodsA qualitative research design was used to assess and triangulate the stakeholder perspectives. Semi-structured interviews were conducted with ART service-users (n = 35), policy actors (n = 20); telephone interviews with prior caregivers of orphans (n = 10); and three focus group discussions with service-providers (hospital staff and volunteers) from a district, provincial and a university hospital.
findingsChildren accessing HIV care were often orphaned, cared for by elderly relatives and experiencing multiple vulnerabilities. Services were divided into three stages, 1. Diagnosis and linkage: Despite strong policies there were supply and demand-side gaps in the prevention of mother-to-child transmission 'cascade' preventing early diagnosis and/or treatment. 2. Maintenance on ART - Children did well on treatment; caregivers took adherence seriously and valued the quality of services. Drug resistance, adherence and psychosocial issues were important concerns from all perspectives. 3. Adolescents and transition: Adolescent service-users faced greater complexity in their physical and emotional lives for which providers lacked skills; transition from the security of paediatric clinic was a daunting prospect. Dedicated healthcare providers felt they struggled to deliver services that met service-users' diverse needs at all stages. Child- and adolescent-specific elements of HIV policy were considered low priority.
conclusionsUsing the notion of the continuum of care a number of strengths and weaknesses were identified. Features of paediatric services need to evolve alongside the changing needs of service users. Peer-support volunteers have potential to add continuity and support at all stages. It is critical that adolescents receive targeted support, particularly during transition to adult services.
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