Harnessing the strength of youth- led adherence interventions. Baylor College of Medicine Children’s Foundation- Uganda Text xxx00.#####.ppt 11/12/2018 2:08:48 AM

Baylor College of Medicine Children’s Foundation- Uganda is affiliated to Baylor International Pediatrics AIDS Initiative based in Houston Texas. Largest pediatric and adolescent HIV care and treatment facility in Africa with a COE (> 7000 clients) in the capital Kampala. Cares for 26% of Uganda’s children and adolescents and 70% of them are younger than 15.

Presenters Brian Hastings Nganwa, Suzan Kansiime. Annet Nassaka, Abel Niyonzima. Esther Kangave, Jacqueline Balungi Kanywa. Edward D. Pettitt, Sabrina Bakeera- Kitaka.

Presentation over view Mission and vision/ Introduction Shaping the future of HIV education Sexual Health promotion Q& A and Discussion Conclussions

Vision and Mission Vision: A healthy and fulfilled life for every HIV infected and affected child & their family in Africa Mission: To provide high-quality family-centered paediatric and adolescent health care, education and clinical research world wide.

Shaping the future of HIV education Introduction: Life experiences by Brian Hastings Nganwa, Suzan Kansiime and Annet Nassaka

HIV education approach at Baylor- Uganda Brief history of Mulago Teen’s Club Clubs within the Mulago Teens Club Camps (Sanyuka, Hope) Adherence and sex education during peer support activities

Sexual health promotion and youth led adherence interventions at Baylor- Uganda. Globally: Policy to integrate HIV/ AIDS and SRH services 2004. About 75% of HIV infections are sex related.

Sexual health promotion and youth led adherence interventions at Baylor- Uganda. Nationally: 8 million adolescents with an HIV prevalence rate of 5.1% (2011) up from 1.5 % (2004). In 2013 there were 15, 000 new infections among adolescents 10- 19 years. 50% of Ugandans engage in sex before they are 18 years old.

Sexual health promotion and youth led adherence interventions at Baylor- Uganda. Only 38% of eligible adolescents receiving ART country wide. Sabrina et al (2008) and Nabukeera et al (2009)- HIV infected adolescents engage in unsafe sexual relationships. On going development of an adolescent curriculum at the national level.

Sexual health promotion and youth led adherence interventions at Baylor- Uganda. Talk about adolescents/ Young people= Talk about sex = talk about sexual health promotion. Slogan at Baylor- Uganda: HIV stops with me! Calls for adherence to ART and safe sex practices. ART adherence= low population VL= less new infections= reduced MTCT= HIV free generation.

Sexual health promotion and youth led adherence interventions at Baylor- Uganda. Adherence to life long ART. Age structured peer support through Mulago Teens Club. Disclosure= club membership from age 9. Routine 6 monthly and targeted counseling, CBHC. Health worker friendly engagement at all levels to support adherence; pill counting, peer counselors, personalized education on clinical symptoms, CD4 and VL counts, education on ART.

Emphasis on a treatment buddy, ART time reminders e. g Emphasis on a treatment buddy, ART time reminders e.g. alarms, skills building. Age structured adolescent clinic every Tuesday 10- 13; 14- 16; 17- 19; 20 and over. Teen mothers club. HEADSS approach when dealing with teens.

Table showing age categories among clients attending Baylor- Uganda Age group (years) Absolute number Percentage 0 – <10 3097 44 10- <14 1279 18 14- <17 808 12 17- <20 555 8 20- 24 576 25 and older 706 10 TOTAL 7021 100 Approximately 2, 663 (38%) adolescents aged 10- 19 years and 576 (8%) young people aged 20- 24 years. xxx00.#####.ppt 11/12/2018

Sexual health promotion and youth led adherence interventions at Baylor- Uganda. Services offered: Health education, STI screening and treatment, antenatal care/ referral, FP, Cervical cancer screening and confidential condom demonstration/ distribution.

Table showing services offered from January to June 2014 Service offered Numbers Targeted health education 430 Family planning 53 (50% prefer injectables) Urine hCG for pregnancy 81 (5 % positivity) STI syndromic management 14 Male condoms distributed 4124 Cervical cancer screening 52 (6 % positivity with VIA, all cryotherapy) A 2013 survey showed 4- 14 % positivity.

References www.unicef.org/infobycountry/uganda_statistics.ht ml; dhsprogram.com/pubs/pdf/PR18/PR18.pdf www.who.int/entity/hiv/pub/sti/inventory/en Baylor- Uganda data base. Adolescents Living with HIV in Uganda: Michaela Kerrissey