The HIV care and treatment cascade of adolescents and young adults living with HIV in sub-Saharan Africa

Abstract

BACKGROUND : The Joint United Nations Programme on HIV/AIDS called for the end of the HIV pandemic by 2030 by setting the 95-95-95 HIV cascade targets. This cascade is used to monitor the progress of different populations in different settings. The progress of adolescents and young adults (AYA) living with HIV in sub-Saharan Africa (SSA) toward these targets remains unknown. We propose to conduct a systematic review and meta-analysis to assess the proportion of AYA retained at each step of the HIV care cascade in SSA. METHOD : Studies published between 2015 to date that reported on the HIV care cascade among AYA in SSA will be included. The following databases will be searched: PubMed/MEDLINE, Embase, Scopus, CINAHL, African Index Medicus (AIM), African Journals Online (AJOL), SABINET African Journals, HINARI (for institutional access to global journals) and University institutional repositories and gray literature sources will be searched. Two reviewers will independently screen titles and abstracts, assess the full texts for eligibility, and extract data. Disagreements will be resolved by consensus and consultation with a third reviewer. The number and proportion of AYA retained in the HIV care cascade from HIV diagnosis, initiation of ART, and viral suppression will be used for the meta-analysis. Random-effect statistical models will be used to estimate the pooled proportion of AYA retained at each step of the cascade. The results will be graphically represented via forest plots. Variability across studies will be assessed via heterogeneity test statistics (I2). DISCUSSION : This systematic review aims to synthesize current evidence and identify gaps in the treatment cascade. The findings of this meta-analysis provide guidance for designing a framework to improve the care and treatment of AYA living with HIV. SYSTEMATIC REVIEW REGISTRATION : PROSPERO registration number CRD42024561024.