Assessment of the Influence of Adolescent-Youth Friendly Health Services on HIV-related quality of life (AYLHIV) in Taraba State, Nigeria
Abstract:
Adolescents and youth living with HIV (AYLHIV) face
unique challenges impacting their mental, emotional, and social well-being. In
Nigeria, where youth-friendly healthcare services are evolving, the true
influence of Adolescent and Youth-Friendly Health Services (AYFHS) on
HIV-related quality of life (HRQoL) remains unclear. This study assessed the
impact of AYFHS on the HRQoL of AYLHIV in Taraba State, Nigeria. Informed
consent was obtained from all participants. A cross-sectional comparative study
was conducted among 386 AYLHIV aged 10–24 years, comprising 193 AYFHS attendees
and 193 non-attendees using a multistage sampling method. Data were collected
via a structured, interviewer-administered questionnaire covering
Anti-retro-viral therapy (ART) adherence, stigma, resilience, and overall
quality of life. Analyses were performed using SPSS version 27, with t-tests
and multiple regressions applied to determine group differences. Findings
revealed that AYFHS attendees had significantly better ART adherence (78% vs.
62%), higher resilience (81% vs. 54%), and greater confidence in managing HIV
in AYLHIV attendees. The AYLHIV attendees were also more hopeful about the
future and less likely to feel ashamed of their status. Enhanced social
support, peer- engagement, and provider friendliness were key contributing
factors. Non-attendees reported greater emotional distress and lower treatment
confidence. These results demonstrate that AYFHS attendees significantly
improve HIV-related quality of life among adolescents. In conclusion, expanding
youth-friendly models maybe essential for improving treatment outcomes and
addressing psycho-social needs, contributing to Nigeria’s progress toward
achieving UNAIDS 95-95-95 goals.
References:
[1].
U.S. Department of Health and Human
Services, 2020, What is HIV?https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-is-hiv
[2].
UNAIDS, 2020, Seizing the moment:
Tackling entrenched inequalities to end epidemics – Global AIDS Update 2020.
Joint United Nations Programme on HIV/AIDS (UNAIDS). https://www.unaids.org/sites/default/files/media_asset/2020_global-aids-report_en.pdf
[3].
Bekker, L.-G., Johnson, L., Wallace, M.,
& Hosek, S., 2015, Building our youth for the future. Journal
of the International AIDS Society, 18(2Suppl 1), 20027. https://doi.org/10.7448/IAS.18.2.20027
[4].
Slogrove,
A. L., Sohn, A. H., Belecourt, C., Violari, A., & McNairy, M. L., 2020, Adolescents
and young people with HIV: Unmet needs in the global response. Current
Opinion in HIV and AIDS, 15(1), 36-42. https://doi.org/10.1097/COH.0000000000000590
[5].
UNFPA,
2021, Youth-friendly health services: An assessment of youth access to
adolescent sexual and reproductive health services in Nigeria. United
Nations Population Fund Nigeria. https://nigeria.unfpa.org/en/publications/youth-friendly-health-services-assessment
[6].
Mark,
D., Armstrong, A., Andrade, C., Penazzato, M., Hatane, L., Taing, L., &
Bekker, L.-G., 2021, Adolescent HIV treatment in the era of Universal
Health Coverage: Lessons from South Africa and beyond. Journal of the
International AIDS Society, 24(Suppl 2), e25652. https://doi.org/10.1002/jia2.25652
[7].
UNICEF,
2020, Improving Adolescent HIV Care and Treatment: A Peer Support Model for
Africa. United Nations Children’s Fund.
[8].
Govender,
K., Naicker, S. N., Meyer-Weitz, A., Fanner, J., Naidoo, A., & Penfold, L.,
2020, Adolescent access to HIV prevention services in sub-Saharan Africa: A
scoping review and narrative synthesis. African Journal of AIDS
Research, 19(4), 267-275. https://doi.org/10.2989/16085906.2020.1861320
[9].
UNAIDS,
2022, In Danger: UNAIDS Global AIDS Update 2022. Joint United Nations Programme on
HIV/AIDS.
[10]. National Bureau of Statistics (NBS), 2020, 2020
Statistical Report on Women and Men in Nigeria. Federal Republic of
Nigeria. https://www.nigerianstat.gov.ng
[11]. National Agency for the Control of AIDS
(NACA), 2020, Revised National HIV and AIDS Strategic Framework 2019–2021.
Federal Republic of Nigeria. https://naca.gov.ng/revised-national-hiv-and-aids-strategic-framework-2019-2021/
[12]. PEPFAR Nigeria, 2023, Nigeria Country
Operational Plan (COP/ROP) 2023 Strategic Direction Summary. U.S. President’s Emergency Plan for AIDS
Relief. Retrieved
from https://www.state.gov/wp-content/uploads/2023/07/Nigeria_COP23_SDS_Final.pdf
[13]. Busza, J., Besana, G. V. R., Mapunda, P.,
&Oliveras Rodriguez, M. L., 2020, Meeting the needs of adolescents living
with HIV through differentiated care: Lessons from the Zvandiriprogramme in
Zimbabwe. Journal of the International AIDS Society, 23(S5), e25552. https://doi.org/10.1002/jia2.25552
[14]. UNAIDS & World Health Organization,
2021, Adolescent HIV prevention and treatment: A situational analysis of
adolescent HIV programming in selected countries in sub-Saharan Africa. Retrieved from https://www.unaids.org/en/resources/documents/2021/adolescent-hiv-prevention-and-treatment
[15]. O’Brien, K. K., Tynan, A. M., Nixon, S. A.,
& Glazier, R. H., 2020, Effectiveness of aerobic exercise for adults living
with HIV: Systematic review and meta-analysis using the Cochrane Collaboration
protocol. BMC Infectious Diseases, 20(1), 73.https://doi.org/10.1186/s12879-020-4779-1
[16]. Denison, J. A., Banda, H., Dennis, A. C.,
Packer, C., Nyambe, N., Stalter, R. M., Mwansa, J. K., & McCarraher, D. R.,
2020, “The sky is the limit”: Adhering to antiretroviral therapy and HIV
self-management from the perspectives of adolescents living with HIV and their
caregivers. Journal of the International AIDS Society, 23(3), e25470. https://doi.org/10.1002/jia2.25470
[17]. Pantelic, M., Boyes, M., Cluver, L., &
Thabeng, M., 2020, ‘They Say HIV is a Punishment from God or from Ancestors’:
Cross-Cultural Adaptation and Psychometric Assessment of an HIV Stigma Scale
for South African Adolescents Living with HIV (ALHIV-SS). Child Indicators
Research, 13(1),
149–170. https://doi.org/10.1007/s12187-019-09660-0
[18]. Willis, N., Milanzi, A., Mawodzeke, M.,
Dziwa, C., Armstrong, A., Yekeye, I., Keatinge, J., & Cowan, F. M., 2020,
Effectiveness of community adolescent treatment supporters (CATS) interventions
in improving linkage and retention in care, adherence to ART and psychosocial
well-being: A randomised trial among adolescents living with HIV in rural
Zimbabwe. BMC Public Health, 20, 117. https://doi.org/10.1186/s12889-019-7995-4
[19]. Mburu, G., Ram, M., Skovdal, M., Bitira,
D., Hodgson, I., Mwai, G. W., & Seeley, J., 2020, Supportive social
relationships and improved health-related quality of life among adolescents living
with HIV in sub-Saharan Africa: A structural equation modelling analysis. AIDS Care, 32(1), 6-15. https://doi.org/10.1080/09540121.2020.1739203
[20]. de Terte, I., Becker, L. A., & Marks,
D. F., 2020, Resilience and quality of life among people living with HIV: A
systematic review of quantitative studies. Journal of Health
Psychology, 25(6),
709-723.https://doi.org/10.1177/1359105317718053
[21]. Shah, S. K., Celum, C., Baeten, J. M.,
Bukusi, E., & Pintye, J., 2021, Resilience among adolescents living with
HIV: A review of global literature. AIDS Care, 33(6), 713-720. https://doi.org/10.1080/09540121.2020.1742864
[22]. Mark, D., Armstrong, A., Andrade, C., Penazzato, M., Hatane, L., Taing, L., & Bekker, L.-G., 2021, Adolescent HIV treatment in the era of Universal Health Coverage: Lessons from South Africa and beyond. Journal of the International AIDS Society, 24(2), e25652.https://doi.org/10.1002/jia2.25652
