Andrew Sentoogo Ssemata, BCP, MSc, PhD
ANDREW SENTOOGO SSEMATA
Nominated From: Indiana University
Research Site: Global Health Uganda
Research Area: Adolescent HIV care
Primary Mentor: Leslie A Enane
Research Project
Get Set and Go: Co-designing and Evaluating the Implementation Readiness of an HIV Transition Support Package for Adolescents and Young People in Kampala, Uganda.
My first NPGH fellowship year examined barriers, facilitators, and experiences related to transition from pediatric to adult HIV services among adolescents and young people (AYP). The findings highlight the need for a structured, youth-responsive transition model or toolkit that can support AYP as they prepare for, navigate, and sustain engagement in adult-oriented HIV care. Specifically, the findings point to the importance of psychosocial support, HIV disclosure support, stigma reduction, transition readiness assessment, HIV self-management skills, caregiver engagement, and peer support as potential components of a transition support package. The senior fellowship year builds on these findings to refine, operationalize, and assess the implementation readiness of a youth-responsive transition support package for use in routine HIV care. This second-year project moves beyond describing transition challenges and the initial reflections on the co-design approach, to 1) establish essential elements for adolescent HIV transition models; 2) co-design and refine the transition support package and operationalize its components; and 3) evaluate the anticipated feasibility, acceptability, and appropriateness of the refined transition support package for implementation in HIV clinics in Kampala. Therefore, our first objective is to use a modified Delphi process to establish consensus among clinicians and experts in adolescent health and HIV and among AYP on core components, processes, and desired outcomes of a transition support model for AYP living with HIV. Next, we will co-design and refine the design of the package and tools for its implementation (SOPs, training manual, systematic transition guide, patient materials in a youth-friendly format such as a comic book). Finally, we will conduct human-centered design testing workshops in 3 clinics to demonstrate the package and its prototype components, and evaluate the anticipated feasibility, acceptability, and appropriateness of the package for implementation in this setting. Feedback will be used to update the final package. Findings across these objectives will build on our developing evidence around supporting transition for adolescents with HIV, and will provide preliminary data for funding applications to pilot the refined package with AYP living with HIV.
Research Significance
Publications
Mentors
Andrew Sentoogo Ssemata, BCP, MSc, PhD
Nominated From: Indiana University
Research Site: Global Health Uganda
Research Area: Adolescent HIV care
Primary Mentor: Leslie A Enane
Research Project
Get Set and Go: Supporting transitions from pediatric to adult HIV services for adolescents and young people in Kampala, Uganda
Adolescents and young people (AYP) living with HIV have worse care outcomes than their adult counterparts. Despite the successes of antiretroviral therapy (ART) scale-up, this group faces unique challenges, especially during the transition from pediatric to adult HIV care. This transition involves more than a change in care setting; it requires AYP to take on responsibility for care engagement, with potential for poor ART adherence, loss to follow-up, and negative health outcomes. This mixed-methods participatory action research study aims to address barriers to successful transition for AYP (ages 13-24 years) in Uganda. The study has three goals: first, to conduct a scoping review of practice and transition models from pediatric to adult HIV care services for adolescents and young people living with HIV in the African context. Secondly, to generate mixed-methods data on transition readiness, experiences, and challenges for AYP, and how this process relates to HIV care engagement and mental well-being. Thirdly, to co-create with AYP and pilot an innovative transition support model tailored to AYP needs, which will be appropriate, feasible, and scalable across clinics in this setting. The research will be conducted at HIV clinics in Kampala and will involve a mixed methods process using human-centered design approaches i.e. structured questionnaires, in-depth interviews, and design workshops with AYP, peer supporters, healthcare providers, and caregivers. Data will be analyzed using a mixed-methods approach. The significance of this study lies in its potential to inform evidence-based transition strategies that enhance the care engagement and health outcomes of AYP living with HIV. By involving all relevant stakeholders in the co-creation process, the study aims to produce a practical and context-specific transition model that can be implemented in similar settings, contributing to the achievement of UNAIDS 95-95-95 goals and improving the overall health and well-being of adolescents and young people in Uganda and beyond.
Research Significance
This research addresses a critical gap in HIV care for adolescents and young people (AYP) in Uganda by focusing on the complex and underexplored process of transitioning from pediatric to adult HIV services. AYP living with HIV face heightened vulnerability due to developmental, psychosocial, and structural challenges that compromise treatment adherence and continuity of care. Inadequate transition support leads to preventable health deterioration, loss to follow-up, and increased mortality. This study aims to develop a contextually relevant transition model that strengthens long-term care engagement, promotes self-management, and improves health outcomes. By targeting a neglected phase in the HIV care continuum, the research will not only benefit a high-risk, underserved population in Uganda but also contribute to global efforts to achieve the UNAIDS 95-95-95 targets.
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