dc.contributor.author |
Mathews, C.
|
|
dc.contributor.author |
Cheyip, M.
|
|
dc.contributor.author |
Beauclair, R.
|
|
dc.contributor.author |
Puren, A.
|
|
dc.contributor.author |
Lombard, C.
|
|
dc.contributor.author |
Jonas, K.
|
|
dc.contributor.author |
Ayalew, K.A.
|
|
dc.contributor.author |
Govindasamy, D.
|
|
dc.contributor.author |
Kuo, C.
|
|
dc.contributor.author |
Dietrich, J.
|
|
dc.contributor.author |
Abdullah, Fareed
|
|
dc.contributor.author |
Gray, G.
|
|
dc.date.accessioned |
2022-10-18T09:32:07Z |
|
dc.date.available |
2022-10-18T09:32:07Z |
|
dc.date.issued |
2021-05 |
|
dc.description.abstract |
BACKGROUND. Health service coverage cascades measure the proportion of a population in need of a service that experienced a positive health
outcome from the service, and enable tracking of progress in achieving universal health coverage and inequities in care coverage.
OBJECTIVES. To investigate HIV care coverage among HIV-positive adolescent girls and young women (AGYW) living in six South African
districts, compare coverage by age and socioeconomic status (SES), and investigate other associated factors including participation in a
combination HIV prevention intervention.
METHODS. The HERStory Study was an evaluation of the combination intervention, comprising a representative household survey of
AGYW aged 15 - 24 years living in six intervention districts. From September 2017 to November 2018, biological, sociodemographic and
behavioural data were collected. HIV-positive status, initiation of antiretroviral therapy (ART) and viral suppression were determined
through laboratory tests (enzyme-linked immunosorbent assay for HIV antibodies, antiretroviral (ARV) metabolites and viral load (VL)
testing). Viral suppression was defined as a VL <1 000 copies/mL. Knowledge of HIV-positive status was self-reported, and participants
testing positive for ARV metabolites were assumed to have known their HIV-positive status. Unconditional HIV care cascades were created,
stratified by age and SES. We used Pearson’s χ2
tests corrected for survey-based analysis to describe factors associated with knowledge of
HIV status, and being on ART.
RESULTS. Of the 4 399 participants, 568 were HIV-positive (12.4%), of whom 60.8% (95% confidence interval (CI) 57.1 - 64.5) knew their status,
50.6% (95% CI 46.6 - 54.0) were on ART, and 62.1% (95% CI 58.4 - 65.9) were virally suppressed. Most participants (84.9%) were in the lower
SES group, and they had better coverage than the higher SES group: 61.9% (95% CI 58.3 - 65.4) knew their status, 52.1% (95% CI 48.4 - 55.9)
were on ART, and 64.9% (95% CI 61.3 - 68.4) were virally suppressed, compared with 55.0% (95% CI 42.1 - 68.0), 40.0% (95% CI 29.2 - 50.8),
and 46.6% (95% CI 34.5 - 58.7), respectively. Participants aged 15 - 19 years had slightly inferior coverage to the 20 - 24-year-old group: 57.5%
knew their status, 46.1% were on ART and 59.5% were virally suppressed, compared with 62.3%, 52.2% and 63.3%.
CONCLUSIONS. These findings emphasise the need to close the gaps in HIV care coverage among AGYW, of whom only 61% knew their HIVpositive status and only 62% were virally suppressed. There is pro-poor inequality in HIV care coverage, with those in lower socioeconomic
groups more likely to be virally suppressed. |
en_US |
dc.description.department |
Internal Medicine |
en_US |
dc.description.librarian |
dm2022 |
en_US |
dc.description.sponsorship |
The South African Medical Research Council (SAMRC), the Global Fund, the South African National Treasury and a CIPHER Growing the Leaders of Tomorrow grant from the International AIDS Society. |
en_US |
dc.description.uri |
http://www.samj.org.za |
en_US |
dc.identifier.citation |
Mathews, C., Cheyip, M., Beauclair, R. et al. HIV care coverage among HIV-positive adolescent girls and young women in South Africa : results from the HERStory Study. South African Medical Journal, vol. 111, no. 5, pp. 460-468, apr. 2021. doi:10.7196/SAMJ.2021.v111i5.15351. |
en_US |
dc.identifier.issn |
2078- 5135 (online) |
|
dc.identifier.issn |
0256-9574 (print) |
|
dc.identifier.other |
10.7196/SAMJ.2021.v111i5.15351 |
|
dc.identifier.uri |
https://repository.up.ac.za/handle/2263/87783 |
|
dc.language.iso |
en |
en_US |
dc.publisher |
Health and Medical Publishing Group |
en_US |
dc.rights |
This open-access article is distributed under
Creative Commons licence CC-BY-NC 4.0. |
en_US |
dc.subject |
Human immunodeficiency virus (HIV) |
en_US |
dc.subject |
Adolescent girls and young women (AGYW) |
en_US |
dc.subject |
HIV care coverage |
en_US |
dc.subject |
HIV prevention intervention |
en_US |
dc.subject |
Age |
en_US |
dc.subject |
Socioeconomic status (SES) |
en_US |
dc.subject |
Antiretroviral therapy (ART) |
en_US |
dc.subject |
Antiretroviral (ARV) |
en_US |
dc.title |
HIV care coverage among HIV-positive adolescent girls and young women in South Africa: Results from the HERStory Study |
en_US |
dc.type |
Article |
en_US |