Enhancing retention in care in HIV-infected adolescents during COVID-19 in Mozambique: results from the DREAM program

Fausto Ciccacci; Flavio Ismael; Veronica Chume; Lina Ruth; Pedro Mbula; Stefano Orlando; Noorjehan Abdul Majid; Maria Cristina Marazzi

doi:10.1515/ijamh-2022-0107

Article

Enhancing retention in care in HIV-infected adolescents during COVID-19 in Mozambique: results from the DREAM program

Fausto Ciccacci , Flavio Ismael , Veronica Chume , Lina Ruth , Pedro Mbula , Stefano Orlando , Noorjehan Abdul Majid and Maria Cristina Marazzi

Published/Copyright: January 30, 2023

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From the journal International Journal of Adolescent Medicine and Health Volume 35 Issue 2

Abstract

Introduction

Around 1,7 million adolescents aged 10–19 years worldwide are infected with HIV, 84% of them living in Sub-Saharan Africa. Mozambique is one of the countries with the highest prevalence of HIV in the world. According to UNAIDS, HIV services for adolescents should be tailored and specifically designed for them.

Methods

We aimed to evaluate a package of activities to enhance the retention of HIV-infected adolescent in Mozambique. We retrospectively reviewed routine data from 7 health centers involved in 26 months, from March 2020 to May 2022. A package of tailored interventions was implemented in all the sites. We reviewed activity data from the included centers.

Results

The median number of patients per center was 343 (IQR: 289–466) at the beginning of the period and 395 (IQR: 322–453) at the end. The median overall retention in care and rate of lost to follow-up at the beginning and the end of the period were respectively: 94.2% (IQR 91.9–97.3%) to 99.0% (IQR 96.8–99.5%), 1.5% (IQR 1–3.2%) to 0% (IQR 0.0–0.3%). The total number of deaths increased reaching a plateau after September 2021. All the indicators improved after the beginning of the intervention, also during COVID-19 pandemic.

Conclusions

Our data support the idea that enhancing retention in care for HIV positive adolescents need tailored interventions, based on deep rooting in the specific social context. Tailored intervention can resist external shock such as COVID-19.

Keywords: Africa; HIV; retention in care

Corresponding author: Fausto Ciccacci, UniCamillus – Saint Camillus International University of Health and Medical Sciences, Rome, Italy, E-mail: fausto.ciccacci@unicamillus.org

Funding source: Agenzia Italiana per la Cooperazione allo Sviluppo

Award Identifier / Grant number: AID 011817/04/6

Acknowledgments

This research was funded by the Italian Cooperation Agency (AICS) through the “Global Fund” call, aimed at supporting cooperation initiatives able to be synergistic with the Global Fund activities. The fund was assigned to the Community of Sant’Egidio, it was aimed to reinforce the response to HIV infections in Mozambique.

Research funding: This research was funded by the Italian Cooperation Agency (AICS) through the “Global Fund” call, aimed at supporting cooperation initiatives able to be synergistic with the Global Fund activities. The fund was assigned to the Community of Sant’Egidio, it was aimed to reinforce the response to HIV infections in Mozambique.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The study site is working in collaboration and agreement with the local and national health authorities. All the information included in the analysis came from routine data, and patients were anonymized before the extraction. Hence, the study was exempted from specific consent.

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Received: 2022-12-01

Accepted: 2023-01-17

Published Online: 2023-01-30

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Articles in the same Issue

https://doi.org/10.1515/ijamh-2022-0107

Keywords for this article

Africa; HIV; retention in care