Date of Conferral

2020

Degree

Ph.D.

School

Health Services

Advisor

Adebowale Awosika-Olumo

Abstract

Human Immunodeficiency Virus (HIV) remains a significant public health problem in Sub-Saharan Africa with poor treatment outcomes in children and adolescents (C&As). There is a lack of information on the effects of various HIV care models (Child and Adolescent Friendly Clinic model and Support Group model) on retention in care and Viral Suppression (VS) in Cameroon. This study was carried out to identify the care model with the best outcomes for C&As, inform national scale-up strategies, resource prioritization, and contribute to the existing literature. A quantitative retrospective cohort review approach guided by the social cognitive theory was used to analyze data on 2,503 C&As aged 0-19 years current on antiretroviral therapy (ART) from January 2018 to September 2019 with a documented viral load result. Data were analyzed using multiple logistic regression and the Kruskal-Wallis one-way analysis of variance tests, and findings were interpreted using the test statistics and p values. The retention at 12 months was not associated with the model of care (OR = 1.014, p = .876). Viral Suppression and medication pickup were not associated with the type of home-based caregiver. The Odds of VS were 1.265 times higher in C&As enrolled in the Child and Adolescent Friendly Clinic model compared with the Support Group model (p = .003). Consequently, this research's findings will impact positive social change by stimulating further studies leading to quality improvement in the HIV domain. Moreover, the results could encourage public health professionals to design and implement effective HIV management programs addressing clinical and psychosocial services needed to improve retention and VS for C&As.

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