Original Research

The effects of Teen Clubs on retention in HIV care among adolescents in Windhoek, Namibia

Farai K. Munyayi, Brian van Wyk
Southern African Journal of HIV Medicine | Vol 21, No 1 | a1031 | DOI: https://doi.org/10.4102/sajhivmed.v21i1.1031 | © 2020 Farai K. Munyayi, Brian van Wyk | This work is licensed under CC Attribution 4.0
Submitted: 06 September 2019 | Published: 03 February 2020

About the author(s)

Farai K. Munyayi, School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa; and, International Training and Education Center for Health, Windhoek, Namibia
Brian van Wyk, School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa

Abstract

Background: Adolescents living with HIV (ALHIV) are notably underserved by the national HIV programmes globally because of their unique needs. Of particular concern is limited access to and availability of adolescent-friendly antiretroviral therapy (ART) services, which contribute to poor retention in care in many sub-Saharan African countries. A Teen Club intervention was introduced in 2010 in Windhoek, Namibia, to improve retention in care among ALHIV through psychosocial support in a peer-group environment.

Objectives: To compare the effects of the Teen Club intervention against standard care on retention in HIV care amongst adolescents at a Paediatric ART clinic.

Method: A retrospective cohort analysis of adolescents aged 10–19 years receiving ART between July 2015 and June 2017 was conducted. Routine patient data were extracted from an electronic database and patient registers. A sample of 385 participants was analysed: 78 in the Teen Club and 307 in standard care. Retention was measured by assessing attendance to prescribed clinic visits up to 24 months. Comparisons were assessed with the Chi-square test, and Kaplan–Meier survival analysis was conducted to analyse differences in retention rates.

Results: The overall retention rate at 24 months among all adolescents was 90.1%, with no statistically significant difference between those in Teen Club (91%) and those in standard care (89%) (p = 0.956). Younger adolescents (10–14 years) had better retention rates at 24 months compared to older adolescents (15–19 years) (94% vs. 86%; p = 0.016). Retention rates were significantly higher for adolescents on first-line ART regimen (vs. second line: hazard ratio [HR] = 0.333; 95% confidence interval [CI] = 0.125–0.889); on ART ≥ 12 months (vs. < 12 months: HR =0.988; 95% CI = 0.977–0.999); and those to whom their HIV status was disclosed (HR = 0.131; 95% CI = 0.025–0.686).

Conclusion: Group-based adherence support interventions did not improve retention rates for younger adolescents in specialised paediatric ART clinics but may still hold the potential for improving retention rates of older adolescents.


Keywords

adolescents; HIV; retention in care; Teen Club; antiretroviral therapy; lost to follow-up; group interventions; adolescent-friendly HIV services

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