Department of Public Health, Lira University, Lira, Uganda.
Department of Nursing and Midwifery, Lira University, Lira, Uganda.
PLoS One. 2023 Jul 13;18(7):e0288410. doi: 10.1371/journal.pone.0288410. eCollection 2023.
Suboptimal utilization of antiretroviral therapy (ART) services remains a problem among adolescents in low- and middle-income countries, which has a negative impact on their response to treatment and increases the risk of developing resistance. Optimal use is essential to enhancing treatment efficacy. We investigated the optimal use of ART service and predictors among adolescents living with HIV (ALHIV) in northern Uganda.
We used a cross-sectional study design to collect quantitative data from 293 ALHIV at three health facilities in Lira municipality, northern Uganda. We used an interviewer-administered questionnaire and data abstraction form. Data were analysed using SPSS version 23 software. Descriptive analysis and logistic regressions were performed to determine the relationship between the predictor and outcome variables. Statistical significance was determined at P-value<0.05 and the adjusted odds ratio with a 95% confidence interval was used.
The level of utilization of ART services was suboptimal among 27.6% (81/293) of the participants, and only 63.1% (185/293) were virally suppressed. Of the participants who were optimally utilizing ART services, the majority 86.8% (184/212) were virally suppressed. Age 10-14 years (aOR = 3.34), the presence of both parents (aOR = 1.85), parental and peer reminders (aOR = 2.91) and (aOR = 0.49) respectively, and being on ART for five years or less were the characteristics related with optimal utilization of ART services.
Not all ALHIV used ART services to their full potential. However, factors such as participants' age, the presence of both parents, reminders from parents and peers, and being on ART for some time were all related to the optimal use of ART services. There is a need for developing strategies to increase family and peer support with a focus on older adolescents if the 95-95-95 goal is to be achieved in this age group.
在中低收入国家，青少年接受抗逆转录病毒疗法（ART）服务的情况并不理想，这对他们的治疗反应产生了负面影响，并增加了产生耐药性的风险。最佳利用是提高治疗效果的关键。我们调查了乌干达北部感染艾滋病毒的青少年（ALHIV）对 ART 服务的最佳利用情况及其预测因素。
我们采用横断面研究设计，在乌干达北部利拉市的三个卫生设施中，从 293 名 ALHIV 中收集定量数据。我们使用访谈者管理的问卷和数据提取表。使用 SPSS 版本 23 软件进行数据分析。使用描述性分析和逻辑回归来确定预测变量和结果变量之间的关系。P 值<0.05 为统计学意义显著，使用调整后的优势比和 95%置信区间。
293 名参与者中，27.6%（81/293）的 ART 服务利用率不理想，只有 63.1%（185/293）的病毒得到抑制。在最佳利用 ART 服务的参与者中，大多数（86.8%，184/212）病毒得到抑制。年龄在 10-14 岁（优势比[aOR] = 3.34）、父母双方均在（aOR = 1.85）、父母和同伴提醒（aOR = 2.91）和（aOR = 0.49），以及正在接受 ART 治疗 5 年或以下是与最佳利用 ART 服务相关的特征。
并非所有 ALHIV 都充分利用了 ART 服务。然而，参与者的年龄、父母双方的存在、来自父母和同伴的提醒以及接受 ART 治疗的时间等因素都与最佳利用 ART 服务有关。如果要在该年龄组实现 95-95-95 目标，就需要制定战略来增加家庭和同伴的支持，重点是年龄较大的青少年。
