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Ruth Henwood
23 October 2017
PATA conference
Youth Care Clubs (YCCs): an adolescent & youth-friendly HIV treatment & care model
“Thereisnoprivacyatthecliniceveryoneseesyouandthereistoomuchjudgementfrom
thestaff.”–YCCmember
“Icanwaitmorethan4hoursattheclinic. Ihavetoremindthenursesometimestotakemyviralloadandcreatinine,andtheydon’tevenaskme
howI’mfeeling.”–YCCmember
- ChangesduringadolescencepresentchallengestoARTadherence1
- Adolescentsneedcontinuityofcareand assistancewithlinkingtocare,andpreventing losstofollowup
à NeedforservicesthataddresstheuniqueneedsthatadolescentsfaceregardingHIVtreatmentandcare
Why Bongi needs differentiated care
1. Hornschuh etal.,2016
YCCmembers
12-15yearolds 6-19yearolds 20-24yearolds
YCCmembers
YCCmembers
SomeYCCmembersarenewonART,somevirallysuppressedonART
andsomearenotyet-virallysuppressedonART
• Monthlymeetingsattheclinic• Laycounsellor-led&clinician
supported• Pre-packedART• Screening:TB,STIs,nutrition,
mentalhealth,contraception• Interactivediscussion• Clinicalcare&psychosocial
support
Youth Care Clubs
YCC counsellor:1. Records members’ height, weight and
symptom check in paper register2. Screens for TB, STIs, nutrition,
psychosocial and contraception 3. Confirms members’ phone number4. Allocates who need to see clinician 5. Documents next YCC date on clinic card
YCC clinician:Regular clinic duties
YCC counsellor:1. Conducts a quick ice breaker2. Introduces the session topic3. Runs through the topic according to the
session plan4. Encourages YCC members to participate
in discussion
YCC clinician:Regular clinic duties
YCC counsellor: 1. Distributes pre-packed ART to VS
members in club room 2. Sends members who need to see
the nurse to her/him3. Sees to late comers4. Counsels members who screen
positive for psychosocial problems
5. Adherence counselling to members as needed
YCC clinician:1. Fast-tracks YCC members 2. Distributes pre-packed ART to NI
& NVS during clinical consultation 3. Provides contraception, blood &
clinical services as indicated 4. Follows up on members who
screens positive for TB, STIs orpoor nutrition
09:00 09:15 10:0010:10
ARTdistribution
HOME
YCCCLINICIAN
YCC counsellor:1. Records members’ height, weight and
symptom check in paper register2. Screens for TB, STIs, nutrition,
psychosocial and contraception 3. Confirms members’ phone number4. Allocates who need to see clinician 5. Documents next YCC date on clinic card
YCC clinician:Regular clinic duties
YCC counsellor:1. Conducts a quick ice breaker2. Introduces the session topic3. Runs through the topic according to the
session plan4. Encourages YCC members to participate
in discussion
YCC clinician:Regular clinic duties
YCC counsellor: 1. Distributes pre-packed ART to VS
members in club room 2. Sends members who need to see
the nurse to her/him3. Sees to late comers4. Counsels members who screen
positive for psychosocial problems
5. Adherence counselling to members as needed
YCC clinician:1. Fast-tracks YCC members 2. Distributes pre-packed ART to NI
& NVS during clinical consultation 3. Provides contraception, blood &
clinical services as indicated 4. Follows up on members who
screens positive for TB, STIs orpoor nutrition
09:00 09:15 10:0010:10
Youth Care Clubs Benefits
Outcomes
No. ofYCCmembers 325
Retention incareat6months 88%
RetentioninYCCcareat6months 75%
Virallysuppressed atlastVL 81%
• Refreshments• Clinichours• Staffing• Space• FrequencyofYCCvisits
• But,thepeersupport aspectorfornewlydiagnosed canbeverybeneficial.
Challenges
“Iwanttocometothecliniceachmonthtoseemy
progress,howIamdoing, totalktothenurse.”–YCCmember
“Ilikegettingmymedication thoughtheYCC.BeforeIhadtowaitalongtimeinaqueuejusttoget
mymedication.”–YCCmember
““[Ilike]beingtherewithmypeers,talkingaboutfearsandexpressinghowwefeelaboutbeingHIVpositiveandhelpingeachotherovercomethis.”
–YCCmember
&Youth Care Club Facilitators: Prosper Ndlovu, Eric Dondolo, Marvellous Ngobeni, Pauline Onneile, Thabo Ziyane
&Programme Manger of Adolescent Innovations Project: Shenaaz Pahad
&YCC members
Acknowledgements