Table 2.

Assessment of youth-friendly models of care: ongoing research in sub-Saharan Africa

Reference, Year	Site	Study Design	Population	Models of care	Outcomes
Patten, J Int AIDS Soc 2013 [45]	Khayelitsha, South Africa	Retrospective before-and-after observational cohort with data collected from May 2010 to April 2011 when CD4+ count are tested in laboratory (Group A) and from August 2011 to July 2012 with same day point-of-care (POC) CD4 testing (Group B) to assess whether there was an associated reduction in attrition between HIV testing, and ART initiation	576 adolescents and young adults living with HIV, ART-naïve and probably recently diagnosed, 12–25 years, 272 in group A and 304 in group B	Youth clinic and offer youth-friendly services to address the needs of this difficult population group. June 2011 POC CD4 cell-count testing was introduced in youth clinic. Both had 3 ART preparation counselling session	– Group B more receive CD4 cell count test result and their eligibility assessed (90% vs. 67%; relative risk [RR] = 2.4, 95%CI:1.8–3.4, p < 0.0001) – No significant difference in the proportion starting and completing ART preparation counselling sessions 56% vs. 58% (p = 0.9). – 8 days reduction in the time from HIV testing to ART initiation in Group B, (p = 0.6). – The proportion of eligible patient who initiated ART was 44% and 50% (p = 0.6) in group A and group B, respectively, and a similar proportion were retained on therapy at three months after initiation (RR = 1.0, 95% CI:0.5–1.2, p = 0.9) – No difference in the proportion of patients lost to follow-up
Nyabigambo, Adolescent health, Medicine and Therapeutics 2014, AIDS care 2014 [40,46]	Kampala, Uganda	Cross-sectional design and quantitative methods to collect data to study the levels (regular/irregular) and determinants (personal, health service delivery and community) of HIV transition clinic (HTC) services utilization by adolescents and young adults living with HIV	379 adolescents and young adults 15–24 years, registered clients at an HTC between March and June 2012	Infectious disease institute, with Wednesday monthly visits, and providing clinical examination, laboratory services, prevention mother-to-child transmission services, family planning services, treatment of sexually transmitted infections, ART psychosocial support, counselling, home visiting, peer support services, skills building programmes	– 32% were regular utilizers of the HTC, mean age 22 years, 61% currently on ART. – 82% of regular utilizers were females No relationship between reported wellbeing (measured with General Well-Being Schedule, 18-point scale) and attending all clinical visits (compared to missing at least one visit) – The most utilized services were: clinical examination (96%), laboratory (87%) and counselling (70%), – The less utilized: home visiting (6%,) peer support (20%). Individual correlates of HTC utilization – urban location: regular 56% vs. irregular 69%, p = 0.016 – age 15–19: regular 15% vs. irregular 9%, p = 0.044 – currently on ART: regular 82% vs. irregular 51%, p = 0.000 – last CD4 < 250: regular 37% vs. irregular 18%, p = 0.000 Community correlates: – not having a caregiver at home: regular 11% vs. irregular 22%, p = 0.014 Health services delivery correlates – no receiving counselling: regular 20% vs. irregular 36%, p = 0.001 Multivariable analysis: CD4 > 251 (adjusted Odds Ratio [AOR] = 0.58 95% CI = 0.36–0.95), not being on ART (AOR = 0.47, 95% CI = 0.15–0.47), not receiving counselling (AOR = 0.47, 95% CI = 0.27–0.83)
McKenney, 2016 unpublished [39]	Lilongwe, Malawi	Assessment of a Transition Training programme, in Baylor College teen Clubs	800 adolescents, 18–24 years, 106 graduate participants, from 2013 to 2015	6-week Transition Training programme to transfer to adolescents economic, psychosocial, and self-care skills needs to make a successful transition into adulthood	Mean age: 20 years 23% have disclosed their HIV status to friends/partners; 25% were enrolled in secondary school, and 3% in university; 10% found employment, 8% were involved as ambassadors for adolescents and young adults; 22% were mentors or peers for teen clubs
Henwood, Aids Care, 2016 [25]	Khayelitsha (Cape Town), South Africa	Self-administered survey and focus groups of MSF youth club members using virtual chat support room	60 adolescents and young adults enrolled in MSF youth clubs surveyed; 12 in focus group	MSF youth care for 12-25-year olds includes “youth clubs” which include “MXit” a cell-phone based virtual chat room for social networking and support	58% of survey respondents were 23-25 years and 83% had a cell phone. 60% had used MXit. 84% felt that offering a service outside the youth club meetings was important; cost and anonymity were concerns