Browsing by Author "Petinger, Charné"

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    Effectiveness, acceptability and feasibility of technology-enabled health interventions for adolescents living with HIV in low- and middle-income countries: A systematic review
    (MDPI, 2023) Crowley, Talitha; Petinger, Charné; Nchendia, Azia Ivo
    Adolescents living with HIV (ALHIV) are challenged to remain adherent and engaged in HIV care. Technology-enabled interventions can be used to optimize healthcare delivery to adolescents. The largest proportion of ALHIV resides in sub-Saharan Africa. This review synthesized the evidence for the effectiveness, acceptability, and feasibility of technology-enabled health interventions for ALHIV in low and middle-income countries (LMIC). Eight electronic databases (Ebscohost, CINAHL, ERIC, MEDLINE, PubMed, SCOPUS, Science Direct, and Sabinet) and Google Scholar were searched to identify studies in LMIC published from 2010 to 2022. Quantitative and qualitative studies reporting on technology-enabled health interventions for predominantly adolescents (10–19 years) were included. The review was performed, and findings were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols.
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    Experiences of adolescents living with HIV on transitioning from pediatric to adult HIV care in low and middle-income countries: a qualitative evidence synthesis protocol
    (Public Library of Science, 2024) Petinger, Charné; Crowley, Talitha; van Wyk, Brian
    In South Africa, it is estimated that approximately 320,000 adolescents living with HIV (ALHIV) will transition from pediatric to adult antiretroviral treatment (ART) by 2028. However, the age period of 10–19 years is accompanied by a myriad of barriers that challenge the transition process, and continued adherence to ART. The transition process involves ALHIV taking charge of their own health and disease management which raises challenges for their retention in care. Managing transition becomes particularly challenging in low-resource contexts as their healthcare systems are not adapted to the specific needs it requires. There is a need to garner an understanding of existing transition practices which address the specific needs of adolescents and is optimized to their requirements and available resources within a low- or middle-income country context. This review will include all qualitative and mixed method studies which will facilitate a deeper understanding the experiences of ALHIV on transition experiences. The review will specifically look at studies conducted in low- and middle-income countries. The included studies must be presented in the English language and published between 2010–2023. The search strategy will be finalized with consultation with an information specialist. All three reviewers will be present throughout all stages of the review. One reviewer will work independently on the initial screening of studies and another reviewer will assist in checks. After data is extracted, the data will be thematically analyzed with the use of Atlas.Ti computer software. No ethics approval is required and the review will be published in peer reviewed journals and submitted to conferences.
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    Experiences of adolescents living with HIV on transitioning from pediatric to adult HIV care in low- and middle-income countries: a qualitative evidence synthesis
    (Multidisciplinary Digital Publishing Institute (MDPI), 2025) Petinger, Charné; Crowley, Talitha; van Wyk, Brian
    (1) Background: Adolescents living with HIV (ALHIVs) experience significant challenges in adhering to treatment and remaining engaged in care as they transition from pediatric to adult HIV care programs. The aim of this qualitative evidence synthesis (QES) was to review qualitative studies that describe how ALHIVs experience transition practices in low- and middle-income countries. (2) Methods: The following databases were searched: PubMed, Wiley Library Online, EbscoHost (PsychARTICLES, MEDLINE, Scopus, CINAHL), the WHO database, Google Scholar, and reference mining of the included studies. The inclusion criteria were as follows: ALHIV 10–19 years old, interventions on the transition period or studies describing transition practices, published between 2012 and 2023, conducted in low- and middle-income countries, English language, and qualitative and mixed-method studies. This review adheres to the PRISMA guidelines. CASP and MMAT were used for methodological quality assessment, and GRADE CERQual was used for the confidence in review findings. (3) Results: Seven articles were included in the final review. The five overarching themes described: (1) transition readiness during the pre-transition phase; (2) structural (health systems) barriers and treatment literacy as challenges during the transition period; and (3) provided accounts of successful post-transition experiences and recommendations for improving the transition process (when these were not experienced as positive), while also describing the individual and collective contexts in which transition took place, as they outlined (4) individual (psychological) barriers and the facilitative role that (5) a supportive environment played in the outcome of the transition process. There was a high level of confidence in transition readiness, while the other themes were assessed as having moderate confidence due to methodological limitations and minor concerns about adequacy or relevance. (4) Conclusions: There is a dearth of qualitative studies on the transition experiences of ALHIVs and on how the transition process impacts adherence, retention in care, and mental well-being. We recommend the development of interventions in the form of a guided transition protocol to improve the transition experiences of ALHIVs.
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    Mapping the transition of adolescents to adult HIV care: a mixed-methods perspective from the Cape Town Metropole, South Africa
    (Multidisciplinary Digital Publishing Institute (MDPI), 2025) Petinger, Charné; van Wyk, Brian; Crowley, Talitha
    (1) Background: Globally, an estimated 1.7 million adolescents (aged 10–19 years) were living with HIV in 2023, with 82% residing in sub-Saharan Africa. For ALHIV, transitioning to adult care involves assuming responsibility for their own health and disease management, posing significant challenges to persistent engagement in care. There is a paucity in health policies guiding this transition in many sub-Saharan African countries. Overburdened and poorly functioning health systems struggle to provide optimal care for ALHIV amidst the rising HIV pandemic in this priority population. (2) Methods: This study employed a mixed-methods design, comprising a descriptive qualitative study with healthcare workers and managers and a cross-sectional survey to examine the practices and pathways in which the transition to adult HIV care occurs in the Cape Town Metropole, South Africa. (3) Results: We delineate three distinct ways in which transition occurs (transfer-only, adolescent-friendly, and supportive transition). A successful transition involves a sufficient level of self-management of their chronic condition and healthcare journey, which is preceded by adequate preparation pre-transition, and the monitoring of engagement post-transition. This ideally requires developing relevant health policies and implementing guidelines signaling political will and providing the impetus and agency of implementation at the service level in South Africa.
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    Patterns of transition of adolescents in an HIV care programme in peri-urban Cape Town, South Africa: a photovoice study
    (SAGE Publications, 2025) Petinger, Charné; van Wyk, Brian; Crowley, Talitha
    Successful transition from paediatric to adult HIV care programme is a critical developmental milestone in the care trajectory of adolescents living with HIV (ALHIV). The transition process involves a shift from a structured, caregiver-supported healthcare model to one that requires independence and self-management. This process should be guided and supportive to ensure continued engagement in care and optimal adherence when ALHIV are transferred. This study utilised photovoice methods to explore the transition experiences of ALHIV in the Cape Town Metropole. Audio-recorded focus group data were transcribed verbatim and subjected to reflexive thematic analysis. Three distinctive patterns of behaviour from ALHIV were identified as themes. Type 1: socially reliant, dependent adolescent who heavily relies on family and peer support and struggles with adherence. Type 2: socially disconnected, hyper-independent adolescent, who is self-reliant, seeks solitude, and is generally resistant to external support. We configured a third (ideal) type, who is interdependent and able to self-manage their chronic condition, but within a supportive health care environment that provides positive healthcare and transition experiences. The findings underscore the need for supportive transition models promoting self-management skills, while facilitating a symbiotic relation with healthcare staff promoting sustained engagement in care well into adulthood. We recommend that adolescent or youth friendly services for ALHIV be expanded to support and monitor the transition process and outcomes in the adult HIV program.
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    The juxtaposition of invalidation and “inviting in”: a qualitative study of bisexual identity in South Africa
    (Routledge, 2024) Petinger, Charné; Jackson, Kyle; Andipatin, Michelle
    Understanding one’s sexual orientation plays a significant role in contributing to one’s sexual identity and developing a coherent sense of self. Misconceptions and prevailing prejudices make it difficult for bisexual individuals to navigate their sexual identities in many societies. Disclosure of one’s identity is accompanied by certain risks depending on how the information is received. However, disclosing one’s identity can also be positive, especially as it assists in fostering relationships. This article derives from a descriptive study involving 14 semi-structured interviews with young adults aged 18–24 who identified as bisexual. Data were subjected to a reflexive thematic analysis. Themes of invalidation, belongingness and reclaiming through ‘inviting in’ were identified. By processing the feelings of invalidation regarding their bisexual identities which were placed upon them by their respective cultural groups, and society in general, participants were able to develop a sense of agency and reclaim their power. Findings highlight the need for further research on bisexuality, particularly in South Africa, and the need to understand how bisexual identity development occurs in interaction with other sexual and gender identities.
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    The juxtaposition of invalidation and “inviting in”: a qualitative study of bisexual identity in South Africa
    (Routledge, 2025) Petinger, Charné; Jackson, Kyle; Andipatin, Michelle
    Understanding one’s sexual orientation plays a significant role in contributing to one’s sexual identity and developing a coherent sense of self. Misconceptions and prevailing prejudices make it difficult for bisexual individuals to navigate their sexual identities in many societies. Disclosure of one’s identity is accompanied by certain risks depending on how the information is received. However, disclosing one’s identity can also be positive, especially as it assists in fostering relationships. This article derives from a descriptive study involving 14 semi-structured interviews with young adults aged 18–24 who identified as bisexual. Data were subjected to a reflexive thematic analysis. Themes of invalidation, belongingness and reclaiming through ‘inviting in’ were identified. By processing the feelings of invalidation regarding their bisexual identities which were placed upon them by their respective cultural groups, and society in general, participants were able to develop a sense of agency and reclaim their power. Findings highlight the need for further research on bisexuality, particularly in South Africa, and the need to understand how bisexual identity development occurs in interaction with other sexual and gender identities.