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CORE ELEMENTS FOR SUCCESSFUL PREVENTION PROGRAMMING WITH ADOLESCENTS LIVING WITH HIV IN RESOURCE-RICH COUNTRIES: EXPERT PERSPECTIVES
SJ Fielden, S Sargeant, S Grant, JC Frankish
Background: Research on HIV-infection in adolescence focuses on primary prevention rather than models of care for those already infected with HIV. There is little information to help service providers to address the complex needs of this emerging population of young people. The objective of this study was to identify and prioritize the core elements of post-infection secondary prevention programs for adolescents living with HIV.
Methods: Following an environmental scan of existing services and relevant research, 15 in-depth interviews were conducted with leading experts (researchers and clinicians) in four resource-rich countries: the United States of America, Canada, Australia, and the United Kingdom. Experts were selected purposively and through snowball sampling. Interviews were transcribed verbatim and analyzed using NVivo software. Analysis was guided by interpretive qualitative inquiry and consisted of thematic coding and a process of decontextualization and recontextualization of the data.
Results: Ten domains of programming emerged from the data indicating that programs should be: accessible, ethical, collaborative, comprehensive, context-driven, youth-centered, sustainable, appropriately staffed, youth-friendly, and normalizing. Subcategories included cultural competence, family influences, participatory planning and capacity-building. Domains and categories were integrated into a planning and evaluation framework, creating an assessment tool for future program delivery. HIV-related stigma was a dominant consideration clearly influencing service delivery and cross-cutting each of the domains. As part of the program planning process, implications for service provision, staff requirements, and indicators of success were key considerations.
Conclusions: Adolescents infected with HIV present complex challenges to both social and healthcare service providers. Core elements for successful programming targeting the needs of the population serves as a heuristic tool for evidence-based service delivery and make programs more accessible for this underserved group of young people.