Viral load non-suppression among adolescents and youth living with HIV in South Africa

Abstract

Background: Despite the increased initiation and uptake of antiretroviral therapy (ART) in South Africa, some people living with HIV (PLHIV) who are on ART still have non-suppressed viral load (VL). Objectives: This study aimed to determine the prevalence of VL non-suppression among adolescents and youth (aged 12 years – 24 years) living with HIV and on ART in South Africa, as well as the factors associated with it. Method: Data from the 2017 South African national HIV prevalence, incidence, behaviour, and communication survey were analysed. The survey used a multistage-stratified cluster sampling design. A backward stepwise multivariable generalised linear model was used to identify factors associated with VL non-suppression. Results: The study included 340 participants aged 12 years – 24 years, with a median age of 21 (interquartile range [IQR]: 18–23). The proportion of adolescents and youth living with HIV and on ART with non-suppressed VL was 19.2% (95% confidence interval [CI]: 14.4–25.3). Approximately 60% of the participants were not on ART. The odds of VL non-suppression were significantly higher among youth aged 15 years – 19 years (adjusted odds ratio [AOR] = 1.63 [95% CI: 1.24–2.13], p = 0.001) and aged 20 years – 24 years (AOR = 1.22 [95% CI: 1.06–1.41], p = 0.005) compared to adolescents aged 12 years – 14 years. The odds were significantly lower among individuals of other races (AOR = 0.80 [95% CI: 0.69–0.92], p = 0.003) compared to black African people. Conclusion: Findings suggest a need for ART education and counselling as part of treatment support. In addition, the promotion of HIV awareness as part of strengthening the HIV treatment and prevention cascade. Contribution: The article showed the prevalence of VL non-suppression and associated factors among adolescents and youth.

Keywords

• hiv
• antiretroviral treatment
• viral load
• non-suppression
• adolescent
• youth
• south africa