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Background

Impact of implementing “adolescent-focused” services in Haiti Rachel Bertrand MD , Lindsey Reif MPH, Serena Koenig MD, JW Pape MD. Background. Half of all new HIV infections High risk for failing to initiate treatment and adhere to ART.

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  1. Impact of implementing “adolescent-focused” services in Haiti Rachel Bertrand MD , Lindsey Reif MPH, Serena Koenig MD, JW Pape MD

  2. 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

  3. 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

  4. 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)

  5. 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).

  6. Results • Over 80% of those diagnosed are young women. • After 5 years of operating the Adolescent HIV Clinic: • ART adherence rates :45% to 70%, • mortality : 13% to 7%, • unwanted pregnancies: 25% to 8%.

  7. Impact of implementing “adolescent-focused” services in Haiti

  8. 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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