STACKing the odds for adolescent survival: health service factors associated with full retention in care and adherence amongst adolescents living with HIV in South Africa

Journal of the International AIDS Society
Lucie D CluverLorraine Sherr

Abstract

There are two million HIV-positive adolescents in southern Africa, and this group has low retention in care and high mortality. There is almost no evidence to identify which healthcare factors can improve adolescent self-reported retention. This study examines factors associated with retention amongst antiretroviral therapy (ART)-initiated adolescents in South Africa. We collected clinical records and detailed standardized interviews (n = 1059) with all 10- to 19 year-olds ever initiated on ART in all 53 government clinics of a health subdistrict, and community traced to include lost-to-follow-up (90.1% of eligible adolescents interviewed). Associations between full self-reported retention in care (no past-year missed appointments and 85% past-week adherence) and health service factors were tested simultaneously in sequential multivariate regression and marginal effects modelling, controlling for covariates of age, gender, urban/rural location, formal/informal housing, maternal and paternal orphanhood, vertical/horizontal HIV infection, overall health, length of time on ART and type of healthcare facility. About 56% of adolescents had self-reported retention in care, validated against lower detectable viral load (AOR: 0.63, CI:...Continue Reading

References

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Citations

Jul 25, 2019·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Roxanna HaghighatAnurita Bains
Jan 8, 2020·AIDS Care·Constance R S Mackworth-YoungAlison Wringe
Sep 12, 2020·Open Forum Infectious Diseases·Susan KamalMarie P Schneider
Jun 24, 2020·AIDS Research and Therapy·Blessings N Kaunda-KhangamwaLenore Manderson
Mar 26, 2021·African Journal of Primary Health Care & Family Medicine·Leone Adams, Talitha Crowley
Oct 29, 2021·Journal of the International AIDS Society·Siyanai ZhouElona Toska

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