HIV care coverage among HIV-positive adolescent girls and young women in South Africa: Results from the HERStory Study

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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


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