Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.
Division of Health Systems and Public Health, Stellenbosch University, Cape Town, South Africa.
PLoS One. 2023 Feb 13;18(2):e0271942. doi: 10.1371/journal.pone.0271942. eCollection 2023.
Adolescent girls and young women (AGYW) aged 15-24 years and adolescent boys and young men (ABYM) aged 15-34 years represent one of the populations at highest risk for HIV-infection in South Africa. The National Department of Health adopted the universal test and treat (UTT) strategy in 2016, resulting in increases in same-day antiretroviral therapy initiations and linkage to care. Monitoring progress towards attainment of South Africa's 95-95-95 targets amongst AGYW and ABYM relies on high quality data to identify and address gaps in linkage to care. The aim of this study is to describe the current approaches for engaging AGYW and ABYM in the treatment continuum to generate knowledge that can guide efforts to improve linkage to, and retention in, HIV care among these populations in KwaZulu-Natal, South Africa.
This is a mixed methods study, which will be conducted in uMgungundlovu district of KwaZulu-Natal, over a 24-month period, in 22 purposively selected HIV testing and treatment service delivery points (SDPs). For the quantitative component, a sample of 1100 AGYW aged 15-24 years and ABYM aged 15-35 years old will be recruited into the study, in addition to 231 healthcare providers (HCPs) involved in the implementation of the UTT program. The qualitative component will include 30 participating patients who were successfully linked to care, 30 who were not, and 30 who have never tested for HIV. Key informant interviews will also be conducted with 24 HCPs. Logistic regression will be used to model the primary outcomes on SDP types, while a time to event analysis will be conducted using a Cox regression model and adjusting the standard errors of the hazard ratio for the clustering of participants within SDPs. For qualitative data, a general inductive approach of analysis will be used.
Findings from the study will be communicated to the study population and results will be presented to stakeholders and at appropriate local and international conferences. Outputs will also include a policy brief, peer reviewed journal articles and research capacity building through research degrees.
15-24 岁的少女和年轻女性（AGYW）以及 15-34 岁的青少年男孩和年轻男性（ABYM）是南非艾滋病毒感染风险最高的人群之一。国家卫生部于 2016 年采用了普遍检测和治疗（UTT）策略，导致当天开始抗逆转录病毒治疗和获得护理的人数增加。监测南非在 AGYW 和 ABYM 中实现 95-95-95 目标的进展情况，依赖于高质量的数据，以确定和解决护理联系方面的差距。本研究的目的是描述目前让 AGYW 和 ABYM 参与治疗连续体的方法，以获取知识，指导努力改善这些人群在南非夸祖鲁-纳塔尔省的艾滋病毒护理的联系和保留。
这是一项混合方法研究，将在夸祖鲁-纳塔尔省乌姆古伦杜洛地区进行，为期 24 个月，在 22 个有目的地选择的艾滋病毒检测和治疗服务提供点（SDP）进行。在定量部分，将招募 1100 名 15-24 岁的 AGYW 和 15-35 岁的 ABYM，以及 231 名参与实施 UTT 计划的医疗保健提供者（HCP）。定性部分将包括 30 名成功获得护理的参与患者、30 名未获得护理的患者和 30 名从未接受过艾滋病毒检测的患者。还将对 24 名 HCP 进行关键知情人访谈。逻辑回归将用于对 SDP 类型的主要结果进行建模，而时间事件分析将使用 Cox 回归模型进行，并调整参与者在 SDP 内聚类的标准误差的危险比。对于定性数据，将采用一般归纳分析方法。
将向研究人群传播研究结果，并将结果提交利益攸关方，并在适当的地方和国际会议上展示。产出还将包括政策简报、同行评议的期刊文章和通过研究学位进行研究能力建设。
