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Health Care Experiences of Youth Living With HIV Who Were Lost to Follow-up in Western Kenya

Wolf, Hilary T. MD*; Davidoff, Katharine MD; Auerswald, Colette L. MD, MS; Halpern-Felsher, Bonnie L. PhD; Bukusi, Elizabeth A. MBChB, MMed, MPH, PhD; Lyon, Maureen PhD; Cohen, Craig R. MD, MPH

Journal of the Association of Nurses in AIDS Care: September-October 2019 - Volume 30 - Issue 5 - p 539–547
doi: 10.1097/JNC.0000000000000044
Research Article

HIV is the leading cause of mortality for youth in sub-Saharan Africa. Youth are more likely than any other age group to be lost to follow-up (LTFU) from care. We investigated the health care–related experiences of youth living with HIV (YLWH) who were LTFU (i.e., had not returned to care for at least 4 months), as well as the perceptions of the community health workers who supported them. Data were collected from two focus group discussions with community health workers (n = 18) who worked with YLWH and 27 semistructured interviews with YLWH (ages 15–21 years) who were LTFU. Attitudes toward health care were presented in the context of a social–ecological model. Respondents highlighted the need for improved youth-oriented services, including youth-friendly clinics and training for care providers about specific needs of YLWH. Researchers should develop and test the impact of these interventions to improve retention of YLWH in care.

Hilary T. Wolf, MD, is an Assistant Professor of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA. Katharine Davidoff, MD, is Chief Resident, Pediatrics, University of Massachusetts, Worcester, Massachusetts, USA. Colette L. Auerswald, MD, MS, is an Associate Professor, University of California Berkeley-University of California San Francisco Joint Medical Program, UC Berkeley School of Public Health, Berkeley, California, USA. Bonnie L. Halpern-Felsher, PhD, is Professor of Pediatrics, Stanford University, Stanford, California, USA. Elizabeth A. Bukusi, MBChB, MMed, MPH, PhD, is Director, Family AIDS Care and Education Services-Kenya Medical Research Institute, Nairobi, Kenya. Maureen E. Lyon, PhD, is Professor, Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA. Craig R. Cohen, MD, MPH, is a Professor of Obstetrics, Gynecology, and Reproductive Health Sciences, University of California San Francisco, San Francisco, California, USA.

Corresponding author: Hilary T. Wolf, e-mail:

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

© 2019 Association of Nurses in AIDS Care
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