Please use this identifier to cite or link to this item: http://hdl.handle.net/10311/1878
Title: We did not know what was wrong-barriers along the care cascade among hospitalized adolescents with HIV in Gaborone, Botswana
Authors: Enane, Leslie A.
Mokete, Keboletse
Joel, Dipesalema
Daimari, Rahul
Tshume, Ontibile
Anabwani, Gabriel
Steenhoff, Andrew P.
Lowenthal, Elizabeth D.
Mazhani, Loeto
Keywords: Adolescents with HIV
hospitalized adolescents with HIV
mortality
barriers
care among adolescents
Gaborone
Botswana
Issue Date: 9-Apr-2018
Publisher: Public Library of Science,www.plos.org/
Citation: Mazhani, L. et al (2018) We did not know what was wrong-barriers along the care cascade among hospitalized adolescents with HIV in Gaborone, Botswana. Plosone, Vol. 13, No. 4, pp.1-15
Abstract: High mortality among adolescents with HIV reflects delays and failures in the care cascade. We sought to elucidate critical missed opportunities and barriers to care among adolescents hospitalized with HIV at Botswana's tertiary referral hospital. We enrolled all HIV-infected adolescents (aged 10±19 years) hospitalized with any diagnosis other than pregnancy from July 2015 to January 2016. Medical records were reviewed for clinical variables and past engagement in care. Semi-structured interviews of the adolescents (when feasible) and their caregivers explored delays and barriers to care. Twenty-one eligible adolescents were identified and 15 were enrolled. All but one were WHO Clinical Stage 3 or 4. Barriers to diagnosis included lack of awareness about perinatal HIV infection, illness or death of the mother, and fear of discrimination. Barriers to adherence to antiretroviral therapy included nondisclosure, isolation, and mental health concerns. The number of hospitalized HIV infected adolescents was lower than expected. However, among those hospitalized, the lack of timely diagnosis and subsequent gaps in the care cascade elucidated opportunities to improve outcomes and quality of life for this vulnerable group.
URI: http://hdl.handle.net/10311/1878
ISSN: 1932-6203
Appears in Collections:Research articles (School of Medicine)

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