Batangira A, Otieno E, Bukiriro AK, Basaza R. Low-transition rates in human immunodeficiency virus-infected adolescents: A cross-sectional mixed study of pediatric to adult care transition in Uganda. World J Clin Pediatr 2025; 14(4): 106404 [DOI: 10.5409/wjcp.v14.i4.106404]
Corresponding Author of This Article
Emmanuel Otieno, Lecturer, School of Public Health, Gudie University Project, Kampala, Uganda. otienomdc@gmail.com
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Health Policy & Services
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Case Control Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 9, 2025 (publication date) through Oct 31, 2025
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World Journal of Clinical Pediatrics
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2219-2808
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Batangira A, Otieno E, Bukiriro AK, Basaza R. Low-transition rates in human immunodeficiency virus-infected adolescents: A cross-sectional mixed study of pediatric to adult care transition in Uganda. World J Clin Pediatr 2025; 14(4): 106404 [DOI: 10.5409/wjcp.v14.i4.106404]
World J Clin Pediatr. Dec 9, 2025; 14(4): 106404 Published online Dec 9, 2025. doi: 10.5409/wjcp.v14.i4.106404
Low-transition rates in human immunodeficiency virus-infected adolescents: A cross-sectional mixed study of pediatric to adult care transition in Uganda
Agnes Batangira, Emmanuel Otieno, Arthur Kiconco Bukiriro, Robert Basaza
Agnes Batangira, Arthur Kiconco Bukiriro, Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Uganda
Emmanuel Otieno, Robert Basaza, School of Public Health, Gudie University Project, Kampala, Uganda
Robert Basaza, Department of Public Health, Uganda Christian University, Mukono, Uganda
Author contributions: Batangira A and Bukiriro AK collected data; Batangira A, Otieno E, and Basaza R drafted the manuscript; all authors revised the manuscript; Batangira A, Otieno E, Bukiriro AK, and Basaza R performed the analyses; all authors contributed to data interpretation, critically revised the manuscript for intellectual content, and approved the final version of the manuscript for publication.
Institutional review board statement: This study was reviewed and approved by the Research Ethics Committee of Faculty of Health Sciences, Uganda Martyrs University, No. 2017–M282-20019.
Informed consent statement: Informed consent was completed by the participants.
Conflict-of-interest statement: The authors report having no relevant conflicts of interest.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The dataset used during the current study is available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Emmanuel Otieno, Lecturer, School of Public Health, Gudie University Project, Kampala, Uganda. otienomdc@gmail.com
Received: February 27, 2025 Revised: April 30, 2025 Accepted: June 24, 2025 Published online: December 9, 2025 Processing time: 247 Days and 11 Hours
Abstract
BACKGROUND
Transition is a critical period for adolescents as they begin to assume responsibility for their own health. Similarly, the shift from pediatric to adult healthcare represents a vulnerable phase, marked by unique challenges in adolescent health care. Despite its importance, only a few studies have explored healthcare transition among adolescents in Uganda.
AIM
To identify factors associated with the transition to adult human immunodeficiency virus (HIV)-centered care among adolescents attending HIV/AIDS clinics in Uganda.
METHODS
A cross-sectional mixed-methods study was conducted among 265 adolescents, randomly selected from three antiretroviral therapy (ART) clinics, using a structured questionnaire. Focus group discussions and key informant interviews were conducted. Individuals aged 10-20 years who were actively enrolled in the ART program between January 4, 2022 and January 30, 2023 were recruited. The primary outcome of interest was the transition to adult care. Bivariate and multivariate analyses were performed for quantitative data, while content analysis was used to analyze qualitative data.
RESULTS
The prevalence of transition to adult care was 40.6%. Most participants were male (53.6%) and fell within the 13-15 age group (35.6%). Multivariate logistic regression analysis identified several factors significantly associated with transition to adult care: Age group 10-12 years [prevalence ratio (PR) = 2.525, 95%CI: 2.121-2.944, P = 0.002], Age group 13-15 years (PR = 1.900, 95%CI: 1.196-3.416, P = 0.001), successful viral load suppression (PR = 1.534, 95%CI: 1.173-1.648, P = 0.016), disclosure of HIV status to relatives (PR = 5.001, 95%CI: 3.411-3.611, P = 0.000), being prepared for transitioning (PR = 5.417, 95%CI: 3.468-7.135, P = 0.041) and having skilled pediatric caregivers (PR = 3.724, 95%CI: 2.084-4.105, P = 0.005).
CONCLUSION
Transition to adult care among adolescents was low. Improving transition outcomes may require strengthening individual support within the family context and integrating transition-focused care into existing specialized clinical settings to enhance the delivery of adolescent-friendly services.
Core Tip: Transitioning adolescents living with human immunodeficiency virus (HIV) to adult-centered care in Uganda remains a critical challenge, with transition rates remaining low. These findings have important implications for improving adolescent healthcare. Specifically: (1) Integrating transition care into existing clinical settings, and (2) Strengthening family support systems may enhance transition outcomes. Additionally, targeted interventions addressing the identified predictors of successful transition can further improve outcomes. These insights can guide policymakers and healthcare practitioners in Uganda and similar settings.
