Healthcare provisions associated with multiple HIV‐related outcomes among adolescent girls and young women living with HIV in South Africa: a cross‐sectional study

Autor: Elona Toska, Siyanai Zhou, Christina A. Laurenzi, Wylene Saal, William Rudgard, Camille Wittesaele, Nontokozo Langwenya, Janina Jochim, Boladé Hamed Banougnin, Laurie Gulaid, Alice Armstrong, Gayle Sherman, Olanrewaju Edun, Lorraine Sherr, Lucie Cluver
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of the International AIDS Society, Vol 27, Iss 2, Pp n/a-n/a (2024)
Druh dokumentu: article
ISSN: 1758-2652
DOI: 10.1002/jia2.26212
Popis: Abstract Introduction Adolescent girls and young women (AGYW) living with HIV experience poor HIV outcomes and high rates of unintended pregnancy. Little is known about which healthcare provisions can optimize their HIV‐related outcomes, particularly among AGYW mothers. Methods Eligible 12‐ to 24‐year‐old AGYW living with HIV from 61 health facilities in a South African district completed a survey in 2018–2019 (90% recruited). Analysing surveys and medical records from n = 774 participants, we investigated associations of multiple HIV‐related outcomes (past‐week adherence, consistent clinic attendance, uninterrupted treatment, no tuberculosis [TB] and viral suppression) with seven healthcare provisions: no antiretroviral therapy (ART) stockouts, kind and respectful providers, support groups, short travel time, short waiting time, confidentiality, and safe and affordable facilities. Further, we compared HIV‐related outcomes and healthcare provisions between mothers (n = 336) and nulliparous participants (n = 438). Analyses used multivariable regression models, accounting for multiple outcomes. Results HIV‐related outcomes were poor, especially among mothers. In multivariable analyses, two healthcare provisions were “accelerators,” associated with multiple improved outcomes, with similar results among mothers. Safe and affordable facilities, and kind and respectful staff were associated with higher predicted probabilities of HIV‐related outcomes (p
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