Document detail
ID

doi:10.1007/s10461-023-04137-6...

Author
Cluver, Lucie D. Shenderovich, Yulia Seslija, Marko Zhou, Siyanai Toska, Elona Armstrong, Alice Gulaid, Laurie A. Ameyan, Wole Cassolato, Matteo Kuo, Caroline C. Laurenzi, Christina Sherr, Lorraine
Langue
en
Editor

Springer

Category

Medicine & Public Health

Year

2023

listing date

8/23/2023

Keywords
adolescents hiv aids mental health health personnel treatment health p < 0 001 ci aor adolescents risk
Metrics

Abstract

Brief tools are necessary to identify adolescents at greatest risk for ART non-adherence.

From the WHO’s HEADSS/HEADSS+ adolescent wellbeing checklists, we identify constructs strongly associated with non-adherence (validated with viral load).

We conducted interviews and collected clinical records from a 3-year cohort of 1046 adolescents living with HIV from 52 South African government facilities.

We used least absolute shrinkage and selection operator variable selection approach with a generalized linear mixed model.

HEADSS constructs most predictive were: violence exposure (aOR 1.97, CI 1.61; 2.42, p < 0.001), depression (aOR 1.71, CI 1.42; 2.07, p < 0.001) and being sexually active (aOR 1.80, CI 1.41; 2.28, p < 0.001).

Risk of non-adherence rose from 20.4% with none, to 55.6% with all three.

HEADSS+ constructs were: medication side effects (aOR 2.27, CI 1.82; 2.81, p < 0.001), low social support (aOR 1.97, CI 1.60; 2.43, p < 0.001) and non-disclosure to parents (aOR 2.53, CI 1.91; 3.53, p < 0.001).

Risk of non-adherence rose from 21.6% with none, to 71.8% with all three.

Screening within established checklists can improve identification of adolescents needing increased support.

Adolescent HIV services need to include side-effect management, violence prevention, mental health and sexual and reproductive health.

Cluver, Lucie D.,Shenderovich, Yulia,Seslija, Marko,Zhou, Siyanai,Toska, Elona,Armstrong, Alice,Gulaid, Laurie A.,Ameyan, Wole,Cassolato, Matteo,Kuo, Caroline C.,Laurenzi, Christina,Sherr, Lorraine, 2023, Identifying Adolescents at Highest Risk of ART Non-adherence, Using the World Health Organization-Endorsed HEADSS and HEADSS+ Checklists, Springer

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