Two or more significant life-events in 6-months are associated with lower rates of HIV treatment and virologic suppression among youth with HIV in Uganda and Kenya. Issue 1 (2nd January 2023)

• Record Type: Journal Article
• Authors: Mwangwa, Florence; Charlebois, Edwin D.; Ayieko, James; Olio, Winter; Black, Douglas; Peng, James; Kwarisiima, Dalsone; Kabami, Jane; Balzer, Laura B.; Petersen, Maya L.; Kapogiannis, Bill; Kamya, Moses R.; Havlir, Diane V.; Ruel, Theodore D.
• Is Part Of: AIDS care. Volume 35:Issue 1(2023)
• Page Start: 95
• Page End: 105
• Publication Date: 2023-01-02
• Subjects: Youth -- HIV -- treatment -- Africa; AIDS (Disease) -- Social aspects -- Periodicals; AIDS (Disease) -- Psychological aspects -- Periodicals; AIDS (Disease) -- Patients -- Care -- Periodicals; Acquired Immunodeficiency Syndrome; 362.1969792
• DOI: 10.1080/09540121.2022.2052260
• Languages: English
• ISSNs: 0954-0121

Abstract

ABSTRACT: Youth living with HIV in sub-Saharan Africa have poor HIV care outcomes. We determined the association of recent significant life-events with HIV antiretroviral treatment (ART) initiation and HIV viral suppression in youth aged 15–24 years living with HIV in rural Kenya and Uganda. This was a cross-sectional analysis of 995 youth enrolled in the SEARCH Youth study. At baseline, providers assessed recent (within 6 months) life-events, defined as changes in schooling/employment, residence, partnerships, sickness, incarceration status, family strife or death, and birth/pregnancy, self-reported alcohol use, being a parent, and HIV-status disclosure. We examined the frequencies of events and their association with ART status and HIV viral suppression (<400 copies/ul). Recent significant life-events were prevalent (57.7%). Having > 2 significant life-events (aOR = 0 .61, 95% CI:0.45-0.85) and consuming alcohol (aOR = 0 .61, 95% CI:0.43-0.87) were associated with a lower odds of HIV viral suppression, while disclosure of HIV-status to partner (aOR = 2 .39, 95% CI:1.6-3.5) or to family (aOR = 1 .86, 95% CI:1.3-2.7), being a parent (aOR = 1 .8, 95% CI:1.2-2.5), and being single (aOR = 1 .6, 95% CI:1.3-2.1) had a higher odds. This suggest that two or more recent life-events and alcohol use are key barriers to ART initiation and achievement of viral suppression among youth living with HIV in rural East Africa. Trial registration: ClinicalTrials.gov identifier: NCT03848728. .