Rethinking HIV care for youth: Insights from qualitative research with youth in Chad

Abstract

AbstractYouth ages 15-24 years are significantly impacted by the HIV/AIDS epidemic, representing approximately 37% of new infections globally. This demographic is especially vulnerable in sub-Saharan Africa, where over 80% of HIV-positive youth reside. In Chad, youth face significant barriers to effective HIV care, including high prevalence rates, particularly among young women, and substantial disparities across regions. Despite overall reductions in new HIV infections, youth remain disproportionately affected, necessitating targeted interventions to improve HIV care outcomes. This study employed thematic analysis to conduct a secondary data analysis of previously collected qualitative data. The analysis focused on understanding the pathways to care for youth living with HIV (YLHIV) in Chad, from diagnosis to antiretroviral therapy (ART) adherence. Data were collected through focus group discussions with 52 youth and 48 service providers, including healthcare workers and community actors. Grounded theory analysis was used to identify barriers and facilitators to HIV care, with data transcribed, translated, and analyzed assisted with ATLAS.ti software (Version 7.6.3). Youth reported significant barriers, including financial constraints, logistical challenges, and fear of stigma. Facilitators included supportive healthcare providers, peer support, and specialized HIV care facilities. Psychological barriers and lack of awareness were also critical factors influencing HIV testing and care engagement. The study highlighted the importance of tailored, youth-friendly services to improve care outcomes. To address the unique challenges faced by youth in Chad, healthcare services must be redesigned with active youth participation to be more adolescent-friendly and supportive. Interventions should focus on reducing stigma, improving accessibility, and providing continuous psychosocial support. By addressing these barriers, it is possible to enhance the HIV care continuum for youth, ultimately improving their health outcomes and contributing to the broader goal of ending the HIV epidemic.