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. 2019 Feb;23(2):513-522.
doi: 10.1007/s10461-018-2255-6.

Virological Non-suppression and Its Correlates Among Adolescents and Young People Living with HIV in Southern Malawi

Eric Umar  1   2 , Judith A Levy  3 , Robert C Bailey  4 , Geri Donenberg  3 , Ronald C Hershow  4 , Mary Ellen Mackesy-Amiti  4
Affiliations

Virological Non-suppression and Its Correlates Among Adolescents and Young People Living with HIV in Southern Malawi

Eric Umar et al. AIDS Behav. 2019 Feb.

Abstract

We examined virological non-suppression (VLN) among youth ages 13-24 years receiving HIV treatment in public health facilities in six southern Malawi districts. We also tested three ART adherence measures to determine how well each identified VLN: pill counts, a Likert scale item, and a visual analogue scale. VLN was defined as HIV RNA > 1000 copies/ml. Of the 209 youth, 81 (39%) were virally non-suppressed. Male gender and stigma were independently associated with VLN; social support and self-efficacy were independently protective. Pill count had the highest positive predictive value (66.3%). Using a pill count cut-off of < 80% nonadherence, 36 (17%) of the youth were non-adherent. Of the adherent, 120 (69%) were viral suppressed. Results indicate the need to address HIV-related stigma and to bolster social support and selfefficacy in order to enhance viral suppression. In the absence of viral load testing, pill count appears the most accurate means to assess VLN.

Keywords: Adherence; Adolescent; Antiretroviral therapy; HIV/AIDS; Virological non-suppression.

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Conflict of interest statement

Conflict of Interest All authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Social Action Theory framework and selected variables
Fig. 2
Fig. 2
Flow diagram of subject recruitment
See this image and copyright information in PMC

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