Publication:

Determinants of successful transition from adolescent to adult HIV treatment in Zambia: a facility-level based comparative study

Background Successful transition from adolescent to adult care has not been extensively evaluated, in Zambia. The study aimed to assess the relationship between facility-based socio-demographic traits and successful transition to adult HIV care, in Zambia.

Methods A retrospective descriptive cross-sectional analysis of 7275 patient files from 718 PEPFAR sponsored facilities. Data was extracted from the National Electronic Health Record (EHR) system and imported into STATA SE v-16 for analysis. Descriptive statistics were calculated on socio-demographic features and facility-level performance. Logistic regression was used to analyse the association between level of facility and successful transition to adult care, comparing third level facilities to lower-level facilities. Chi-square was employed to evaluate the association between socio-demographic traits and effective transition outcomes at a significance level of 0.05.

Results 43.2% had successfully transitioned to adult care. Health posts performed the best, with 57.3% of patients successfully transitioning to adult care. The study found that health post type, private ownership, rural location, and province were significant factors in successful transition. Adolescents in lower-level facilities had a 59.9% success rate compared to those in third-level facilities.

Conclusions The study stresses the importance of health system structure and posits that successful transition depends on many factors, not simply adolescent traits.