amfAR, The Foundation for AIDS Research

Surveying Gaps in Adolescent Care in the Asia-Pacific

Excerpts of the online surveys in (top left to bottom right) English, Thai, Bahasa Indonesia, and Vietnamese 
Excerpts of the online surveys in (top left to bottom right) English, Thai, Bahasa Indonesia, and Vietnamese

Due to increasing access to antiretroviral therapy (ART), more and more children with HIV are surviving into adolescence, and an estimated 2.1 million young people aged 10–19 are now living with the virus in low- and middle-income countries. However, despite the growing need for HIV services catering to the age group, many gaps in care remain. As a result, adolescents now represent the only group of people living with HIV with an increasing rate of mortality, which has led toHIV becoming the second leading cause of adolescent death worldwide. In an effort to improve the care adolescents receive in the Asia-Pacific, TREAT Asia is conducting an online survey to ascertain the current state of adolescent healthcare service provision in the region.

“Right now, it is unclear exactly what clinics and hospitals in low- and middle-income settings are or are not doing to respond to adolescent HIV care and treatment needs,” says Aoy Boonsuk, TREAT Asia education project manager. “And so a first key step for knowing how to improve their health outcomes is to capture data on current clinical and management practices for their care.”

The brief online questionnaire was modeled after a similar survey conducted in Africa in 2014 that was developed by Paediatric AIDS Treatment for Africa (PATA) and the World Health Organization (WHO). Both surveys seek to document general information about clinics and hospitals that are providing adolescent care and to chronicle the scope and quality of the services they provide, including sexual and reproductive health services and services to retain adolescents in care as they transition from pediatric to adult care, when many are lost to follow-up.

“Along with WHO, we set out to undertake a situational analysis of dedicated adolescent services in sub-Saharan Africa in order to highlight both policy priorities and service improvement areas,” says Dr. Daniella Mark, PATA’s executive director. “The results of the study point to the absence of a targeted approach for adolescents and indicate cross-cutting themes that should be addressed in order to establish adolescent-friendly HIV services.” These included inadequate treatment adherence and retention programs, peer support services, and counseling to ease the transition to adult care; poor integration of sexual and reproductive health services; and insufficient data regarding treatment outcomes.

TREAT Asia began distributing its online survey, with support from ViiV Healthcare, in September 2015 and analysis is expected to conclude in June. The survey is being distributed to healthcare providers throughout the region and is available in Bahasa Indonesia, Mandarin Chinese, English, Malay, Khmer, Thai, and Vietnamese.

“Adolescents are a unique population with unique needs that have been neglected in the global HIV response,” says Dr. Annette Sohn, amfAR vice president and director of TREAT Asia. “The concerning results from the Africa survey led us to want to know what is happening in our region as well.”

The PATA and TREAT Asia teams hope that combining their results will provide a broader perspective on the problems adolescents with HIV face in accessing quality healthcare, and inform the development of interventions to improve HIV clinical care programs.