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

• DOI: 10.1002/jia2.26212
• Publication Date: 2024-02-09T05:28:51Z
• Authors: Elona Toska; Siyanai Zhou; Christina A. Laur...; Wylene Saal; William Rudgard; Camille Wittesaele; Nontokozo Langwenya; Janina Jochim; Boladé Hamed Bano...; Laurie Gulaid; Alice Armstrong; Gayle Sherman; Olanrewaju Edun; Lorraine Sherr; Lucie Cluver
• Keywords: Attendance; Cross-sectional study

Abstract Introduction Adolescent girls and young women (AGYW) living with HIV experience poor outcomes 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 from 61 health facilities in a South African district completed survey 2018–2019 (90% recruited). Analysing surveys medical records n = 774 participants, we investigated associations multiple (past‐week adherence, consistent clinic attendance, uninterrupted treatment, no tuberculosis [TB] viral suppression) seven provisions: antiretroviral therapy (ART) stockouts, kind respectful providers, support groups, short travel time, waiting confidentiality, safe affordable facilities. Further, compared between mothers ( 336) nulliparous participants 438). Analyses used multivariable regression models, accounting for outcomes. Results were poor, especially In analyses, two “accelerators,” associated improved similar results Safe facilities, staff higher predicted probabilities p <0.001): past‐week adherence (62% when neither accelerator was reported 87% both accelerators reported), attendance (71%−89%), ART treatment (57%−85%), TB symptoms (49%−70%) suppression (60%−77%). Conclusions Accessible adolescent‐responsive critical improving reducing morbidity, mortality onward transmission AGYW. Combining these maximize benefits,