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Clinical Trial
. 2023 Jan;35(1):95-105.
doi: 10.1080/09540121.2022.2052260. Epub 2022 May 16.

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

Florence Mwangwa  1 , Edwin D Charlebois  2 , James Ayieko  3 , Winter Olio  3 , Douglas Black  2 , James Peng  2 , Dalsone Kwarisiima  1 , Jane Kabami  1 , Laura B Balzer  4 , Maya L Petersen  5 , Bill Kapogiannis  6 , Moses R Kamya  7 , Diane V Havlir  2 , Theodore D Ruel  2
Affiliations
Clinical Trial

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

Florence Mwangwa et al. AIDS Care. 2023 Jan.

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..

Keywords: Africa; HIV; Youth; treatment.

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Figures

Figure 1.
Figure 1.
Recent life-events frequency overall and by sex.
Figure 2.
Figure 2.
Mean number of life-events by subgroup; A: Age, B: ART status.
Figure 3.
Figure 3.
Predictor bivariate odds ratios for HIV viral suppression (<400 copies).
See this image and copyright information in PMC

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