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www.aids2014.org Impact of implementing “adolescent- focused” services in Haiti Rachel Bertrand MD, Lindsey Reif MPH, Serena Koenig MD, JW Pape MD
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www.aids2014.org Background Half of all new HIV infections High risk for failing to initiate treatment and adhere to ART. More than 50% of adolescents on ART had a drug resistant virus and were not considered adherent to treatment. ( GHESKIO/Port-au-Prince ) Only 20% of HIV-infected youth are disclosed
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www.aids2014.org Background Barriers to HIV testing : low perception of personal risk, fear of stigma, “youth- hostile” clinic environments, and lack of provider-initiated HIV testing when youth seek medical attention. Majority of HIV-infected adolescents : not disclosed, unprotected sexual intercourse, late for appointment, increase of morbidity and mortality
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www.aids2014.org Methods Need to improve prevention and treatment in this vulnerable population Developed and implemented ‘adolescent- focused’ services Country’s first Adolescent HIV Clinic Creating the first adolescent community advisory board (CAB)
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www.aids2014.org Results Increased the amount of HIV-infected adolescents diagnosed. Over the last 20 years, 7-fold increase in the number of HIV-infected adolescents ages 15 – 24 years diagnosed Rising from ~ 100 HIV-infected adolescents diagnosed in 1993 to ~700 in 2013 (Figure 1).
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www.aids2014.org Results Over 80% of those diagnosed are young women. After 5 years of operating the Adolescent HIV Clinic: 1. ART adherence rates :45% to 70%, 2.mortality : 13% to 7%, 3. unwanted pregnancies: 25% to 8%.
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www.aids2014.org Impact of implementing “adolescent-focused” services in Haiti
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www.aids2014.org Conclusions The next step is to develop a standard protocol for adolescent HIV services that can be scaled-up as the standard of care in HIV clinics throughout Haiti.
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