# Transitioning from Pediatric to Adult HIV Care in Kenya

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2020 · $565,187

## Abstract

Transitioning from pediatric to autonomous adult care is a vulnerable period when many adolescents drop out
of HIV treatment programs. In contrast to trends in adult HIV infection where mortality is decreasing, rates of
mortality among infected adolescents are increasing in many settings, underscoring the need for
improved transitional care. Standardized transition tools, such as the US-based Got Transition model, have
been developed to help children, caregivers, and providers plan for and execute transition across diverse
chronic diseases; these tools are effective, and widely utilized in the US. However, transition tools are largely
untested in settings with high HIV prevalence, and there are few systematic approaches to transition being
used in Africa. Furthermore, effective transition can only occur alongside HIV disclosure, which can be delayed
due to caregiver concerns about coping, guilt, or inadvertent loss of confidentiality. Transitional care and
pediatric HIV disclosure are complementary urgent priorities for adolescents with HIV.
We propose to adapt the Got Transition tool for use in Kenya where we have previously observed low rates of
retention and disclosure among adolescents. We will utilize nationwide electronic medical records (KenyaEMR)
to determine rates of successful transition in existing youth treatment programs, and determine predictors of
successful transition (Aim 1). We will conduct interviews with adolescents, caregivers, healthcare workers and
policy-makers to inform adaptation of the Got Transition tool for use in Kenya (Aim 2). Finally, we will test a
combined intervention package consisting of the adapted transition tool plus a previously validated disclosure
tool in a cluster randomized trial (Aim 3).
This proposal builds on a >25 year HIV research collaboration between the University of Washington, the
University of Nairobi, and the Kenya National AIDS/STI Control Programme (NASCP). Our collaboration with
NASCOP enables us to conduct research that is impactful, locally relevant, and aligned with national
programmatic approaches to facilitate implementation at scale. Adapting the established Got Transition model
for use in Kenya and combining this with the disclosure toolkit is an efficient approach to address the
continuum between pediatric to adult HIV care, and is expected to result in a novel product that can be
implemented nationally. The study will additionally provide important evidence for a generalizable
approach to improve disclosure and transition for adolescents with HIV infection throughout Africa.

## Key facts

- **NIH application ID:** 9970261
- **Project number:** 5R01HD089850-05
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Grace C. John-Stewart
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $565,187
- **Award type:** 5
- **Project period:** 2016-08-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9970261

## Citation

> US National Institutes of Health, RePORTER application 9970261, Transitioning from Pediatric to Adult HIV Care in Kenya (5R01HD089850-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9970261. Licensed CC0.

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